Abstract Body: Introduction: Combination therapy using many antihypertensive medications is necessary for many hypertensive patients. Taking many medications, however, may cause drug adherence to decline, undermining the effectiveness of treatment. Single-pill combinations (SPCs) have been suggested an easier strategy that could improve blood pressure control and adherence. A difficult evaluation of the advantages of SPCs versus standard multi-pill regimens is still necessary. Our goal was to find out if taking many drugs in one pill enhances blood pressure control and adherence more than taking them separately.
Hypothesis: Patients with out-of-control hypertension (systolic blood pressure ≥140 mmHg) who start combination therapy, single-pill combinations (SPCs) will minimize major heart problems, compared to multi-pill prescriptions, due to increased likely adherence to medication and better-sustained blood pressure control.
Methods: Several databases was searched using PRISMA guidelines for those comparing antihypertensive single- and multi-pill regimens. 14 studies were included in the review (8 were randomized controlled trials, and 6 were observational). We collected figures on how consistently people took their medicines, blood pressure declines, and overall results. Cochrane Risk of Bias was used tool for randomized controlled trials and the Newcastle-Ottawa Scale for studies that were not RCTs.
Results: SPC therapy showed better adherence than having patients follow several-pill regimens. Patients given single-pill combinations had lower blood pressures and were more likely to control their blood pressure during follow-up than who took each medicine separately. Researchers found that patients receiving SPCs tended to stay on therapy and experienced a decreased risk of stopping their treatment early. Even though clinical result data were scarce, the results still pointed toward SPC as the preferred option. RCTs generally had a low chance of bias, and observational studies of good quality confirmed the benefit of using SPCs.
Conclusions: The review fulfills an important need by systematically comparing single-step medications and strategies that use more than one pill daily. Providing therapy as one easy-to-take pill improves patients' ability to stick to their treatment and manage their blood pressure. Using fixed-dose combinations is new and meaningful in treating hypertension and shows that they should be used more widely to gain better results for patients.