Quarter-Dose Antihypertensive Drug Combo Shows Promise Treating High Blood Pressure


Review suggests that low doses of multiple blood pressure drugs may be more effective than a standard dose of only 1 medication.

Quarter-dose combinations of blood pressure-lowering drugs may be more effective in treating hypertension and reducing adverse events compared with standard dosing using only 1 medication.

In a study published in Hypertension, investigators conducted a systematic review and meta-analysis of randomized controlled trials with at least 1 quarter-dose arm and 1 placebo and standard-dose monotherapy arm.

The investigators obtained data from 42 trials involving 20,284 participants with hypertension on various doses of medications or no treatment at all. The 5 main drug classes were ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blocker, and thiazides.

The results of the analysis showed that combining quarter doses of 2 drugs was as effective as a single standard dose of one blood pressure-lowering medication. When 4 medications were combined—–each at a quarter-dose––they were nearly twice as effective as 1 drug at the standard dose.

Adverse events (AEs) from single and dual quarter-dose treatments were similar as placebo, and significantly less from a standard dose of a single antihypertensive medication. Little information was gathered regarding AEs in quadruple quarter-dose therapy.

“Low doses can achieve large effects when used in combination,” co-author Dr Anthony Rodgers, MBChB, PhD, told HealthDay. “What we found was that 4 quarter doses gives a lot of benefit with few apparent [AEs]”

Although the findings show promise, the authors warn that more research needs to be done.

“This new approach to treatment needs more research before it can be recommended more widely,” Rogers told Medical Xpress. “The findings have not yet been tested in large long-term trials. People should not reduce the doses of their current medications.

The CDC estimates that approximately 75 million Americans have high blood pressure, equating to 1 of every 3 adults. This condition costs the United States $48.6 billion per year.

Additionally, individuals with hypertension have an increased risk of heart disease and stroke: 2 leading causes of death in the United States

“Widespread control of blood pressure is generally low, even in high-income countries. The largest global survey of hypertension patients showed 88% of those aware of hypertension are treated with medications, but only 1 in 3 were able to gain control of their blood pressure,” Rodgers said, as reported by Medical Xpress. “Because high blood pressure is so common and serious, even small improvements in management can have a large impact on public health.”

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