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Hypertension

New Study Examines Potential of Quarter-Dose Blood Pressure Regimens

Treatment with one-fourth of a standard dose of blood pressure-lowering medications may help to improve efficacy and tolerability of antihypertensive therapy, according to the results of a recent study.
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While previous research has suggested the potential of low-dose combinations of blood pressure-lowering treatments to benefit efficacy and reduce adverse effects, little data exists on very-low-dose therapy.

The researchers conducted a systematic review and meta-analysis of randomized controlled trials that included at least 1 quarter-dose and 1 placebo and standard-dose monotherapy arm.

Overall, they included 42 studies involving 20,284 participants, of which, 36 comparisons evaluated quarter-dose with placebo, and six of which evaluated dual quarter-dose therapy versus placebo. One study evaluated quadruple quarter-dose.

Compared with standard-dose monotherapy, blood pressure differences achieved with single, dual, and quadruple quarter-dose combinations were +3.7/+2.6 (P<0.001), +1.3/−0.3 (NS), and −13.1/−7.9 (P<0.001) mm Hg, respectively.

Single and dual quarter-dose therapy did not differ significantly from placebo in rates of adverse events, and had significantly fewer adverse events compared with standard-dose monotherapy.

“Quarter-dose combinations could provide improvements in efficacy and tolerability of blood pressure–lowering therapy,” the researchers concluded.

—Michael Potts

Reference:

Bennett A, Chow CK, Chou M, et al. Efficacy and safety of quarter-dose blood pressure–lowering agents [published online June 5, 2017]. Hypertension. doi:https://doi.org/10.1161/HYPERTENSIONAHA.117.09202.