Doctors are usually advised to begin high blood pressure treatment with a diuretic-based strategy, but now an international study has shown that a different single-pill drug combination could be more effective at preventing cardiovascular events such as heart attacks and strokes.
The findings of the randomised study led by a University of Michigan Health System researcher, has actually challenged the way blood pressure is usually treated worldwide.
The researchers in the ACCOMPLISH study compared two drug combinations and the results turned out to be so significant that the trial was stopped early.
Both single-pill combination drugs helped more than 75 percent of people who had high blood pressure and other cardiovascular risk factors get their blood pressure down.
In fact, more importantly, patients in the study taking the combination that included a calcium channel blocker had 20 percent fewer heart-related events than the patients taking the other combination.
For the study, a total of 11,506 study participants took a single tablet that includes two medications. One group received a tablet containing benazepril, which is a type of drug called an ACE inhibitor, and amlodipine, which belongs to a class of drugs known as calcium channel blockers or CCBs. The other pill combined benazepril and hydrochloro-thiazide, a type of diuretic or "water pill."
Scientists observed a 20 percent reduction in cardiovascular events with the ACE/CCB combination tablet.
Currently, national guidelines for the treatment of high blood pressure (also called hypertension) call for patients who need medication to start out on a single pill, usually a diuretic, or water pill, and to add other drugs only as needed to bring pressure down.
However, the new results may actually change those guidelines. The new study suggests physicians no longer give diuretics preferred status in treating patients.
"This robust study showed us that switching patients to a single-pill combination meant that twice as many patients got to their blood pressure goal, regardless of previous therapy," said University of Michigan Health System's Kenneth Jamerson, M.D., the leader of the study.
He added: "The significant reduction in cardiovascular events we observed in patients will, I hope, show physicians that earlier use of a combination medication, especially with amlodipine, may be in the best interest of patients," he says.
The study results have shown that just six months of treatment with either drug combination was enough to bring the blood pressure of 73 percent of patients into an acceptable range.
The drop in blood pressure was despite the fact that two-thirds were already taking some other medication before they entered the study.
The study has appeared in the latest edition of New England Journal of Medicine.