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A single pill with two drugs could transform blood pressure treatment, according to the 2018 European Society of Cardiology (ESC) and European Society of Hypertension (ESH) Guidelines on arterial hypertension published online today in European Heart Journal, and on the ESC website.
The guidelines recommend starting most patients on two blood pressure lowering drugs, not one. The previous recommendation was for step-wise treatment, which meant starting with one drug then adding a second and third if needed. This suffered from "physician inertia," in which doctors were reluctant to change the initial strategy despite its lack of success. At least 80% of patients should have been upgraded to two drugs, yet most remained on one drug.
It is now recognised that a major reason for poor rates of blood pressure control is that patients do not take their pills. Non-adherence increases with the number of pills, so administering the two drugs (or three if needed) in a single tablet "could transform blood pressure control rates," state the guidelines.
Professor Bryan Williams, ESC Chairperson of the Guidelines Task Force, University College London, UK, said: "The vast majority of patients with high blood pressure should start treatment with two drugs as a single pill. These pills are already available and should massively improve the success of treatment, with corresponding reductions in strokes, heart disease, and early deaths."
More than one billion people have hypertension (high blood pressure) worldwide. Around 30-45% of adults are affected, rising to more than 60% of people over 60 years of age. High blood pressure is the leading global cause of premature death, accounting for almost ten million deaths in 2015, of which 4.9 million were due to ischaemic heart disease and 3.5 million were due to stroke. High blood pressure is also a major risk factor for heart failure, atrial fibrillation, chronic kidney disease, peripheral artery disease, and cognitive decline.
[...] Professor Giuseppe Mancia, ESH Chairperson of the Guidelines Task Force, University of Milano-Bicocca, Milan, Italy, said: "We have effective treatments and, theoretically, 90-95% of patients should have their blood pressure under control, but in reality only 15-20% achieve target levels. The 2018 Guidelines aim to improve these poor rates of blood pressure control by introducing a treatment strategy that is simple and easier to follow."
-- submitted from IRC
(Score: 2) by bradley13 on Tuesday August 28 2018, @06:25AM (2 children)
"a major reason for poor rates of blood pressure control is that patients do not take their pills"
So the idea is that people are more likely to take one pill than two. I don't get it, I really don't.
I have minor hypertension, and take a low dose of one medication. There have been days that I've forgotten to take my medicine, almost always when traveling. Otherwise, you build it into your routine. Coffee, breakfast and a pill. In my case, for unrelated reasons, I take two vitamin pills at the same time. Why does it matter whether I have one pill, or two, or three to swallow? The point is the routine.
If someone cannot be bothered to take their medicine, well, there's no cure for stupidity.
Everyone is somebody else's weirdo.
(Score: 2) by sjames on Tuesday August 28 2018, @10:26AM
I wonder that myself. Especially considering that new combination pills come with new patents and amazing new price tags. For a 90% or better discount, I'll somehow manage to take two pills instead of one.
It especially makes no sense when every pharmacy has a variety of dirt cheap pill minders so you don't have to deal with multiple bottles in the morning.
(Score: 2) by donkeyhotay on Tuesday August 28 2018, @03:57PM
You're right. Call me cynical, but I think this is just an excuse to make more money off of existing medications. Lisonpril: $8/month. Furosemide: $8/month. Combined pill: $40/month