Ultra Low-dose Drug Combinations For Treating High Blood Pressure

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Highlights

• Blood pressure is the force of the blood that is being pushed against the walls of the arteries which can carry from the heart to other parts of the body.
• Ultra low-dose combination of 4 drugs were used for the treatment of hypertension.
• The blood pressure levels of the patients were dropped to normal levels in just four weeks.

A small clinical trial of a new ultra low-dose four-in-one pill used for the treatment of hypertension has produced positive results, finds a pilot trial conducted by the George Institute for Global Health.

Around 1.1 billion people in the world are affected with high blood pressure or hypertension.

‘A new 4-in-1 pill was found to treat high blood pressure in just four weeks for every patient who participated in the clinical trial.’

The trial found the blood pressure levels of the patient to have dropped to normal levels in just four weeks.

The research team completed a systematic review of 36 past trials, with around 47,500 patients who were testing single and dual quarter-dose therapy. The study was able to show the benefits and had little or no side effects with low doses of three or four drug combinations.

The results of the trial were published in The Lancet, however exciting larger trials are still needed to see if higher rates could be maintained and repeated.

Professor Chow, director of the Cardiovascular Division at The George Institute in Sydney, said, "Most people receive one medicine at a normal dose but that only controls blood pressure about half the time. In this small trial blood pressure control was achieved for everyone. Trials will now test whether this can be repeated and maintained long-term."

"Minimising side effects is important for long-term treatments - we didn't see any issues in this trial, as you would hope with very low dose therapy, but this is the area where more long-term research is most needed."

"We know that high blood pressure is a precursor to stroke, diabetes and heart attack. The need for even lower blood pressure levels has been widely accepted in the last few years. So this could be an incredibly important step in helping to reduce the burden of disease globally."

Clinical Trial
A quadpill (a single capsule which contains four of the commonly used blood pressure lowering drugs at a quarter dose)or a placebo (dummy pill) was given to 18 patients for over four weeks.

The patients were found to repeat the trial for a further four weeks with patients swapping their course of treatment.

The blood pressure levels were measured hourly for a period of 24 hours at the end of treatment, this would allow the research team to reduce the amount of patients required for the clinical trial.

Findings

• The blood pressure levels of 100% of patients who took part in the trial dropped below 140 over 90. Only 33% of patients who took placebo achieved this rate.
• There were no reported side effects of blood pressure lowering drugs, this may vary from swollen ankles to kidney abnormalities depending on the drug.

Professor Chow, said, "What makes these result every more exciting is that these four blood pressure medications are already in use. We are increasingly finding there are opportunities to treat many common diseases hiding in plain sight. This ultimately means we will be able to deliver life changing medications much more quickly, and more affordably."

Facts on Blood Pressure

• One in every three adults in America have high blood pressure.
• The number of people with hypertension in India is projected to increase 214 million by 2025.
• High blood pressure increases the risk of heart disease and stroke.
• Obesity, smoking tobacco and drinking alcohol are some of the risk factors for blood pressure.
• Blood pressure levels can be controlled by taking regular medications, reducing sodium in the diet and following daily physical activity.

References

1. Prof Clara K Chow et.al. 'Quarter-dose quadruple combination therapy for initial treatment of hypertension: placebo-controlled, crossover, randomised trial and systematic review' The Lancet (2017) ; DOI: http://dx.doi.org/10.1016/S0140-6736(17)30260-X
2. High Blood Pressure Fact Sheet - ( https:www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure.htm )
3. HYPERTENSION IN INDIA - (http://www.cadiresearch.org/topic/hypertension/hypertension-india)

Source: Medindia

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