WEDNESDAY, Sept. 12, 2018 — Single-pill, fixed-dose combination (FDC) treatment may be more effective for improving blood pressure control in older patients, according to a study recently published in PLOS Medicine.
Amol A. Verma, M.D., from St. Michael’s Hospital in Toronto, and colleagues used linked clinical and administrative databases to compare clinical outcomes and medication adherence for patients prescribed one angiotensin-converting enzyme inhibitor or angiotensin II-receptor blocker plus one thiazide diuretic, either as a single-pill FDC or as a multi-pill combination. The authors performed a retrospective cohort study, with five year follow-up, of 13,350 patients aged 66 years or older.
The researchers observed no significant difference in outcomes between groups while patients were on treatment (hazard ratio, 1.06; 95 percent confidence interval, 0.86 to 1.31; P = 0.60). The proportion of total follow-up days covered with medications was significantly greater in the FDC group (70 percent) versus the multi-pill group (42 percent; P < 0.01), and a composite of death or hospitalization for acute myocardial infarction, heart failure, or stroke was less frequent in FDC recipients (3.4 versus 3.9 events per 100 person-years; hazard ratio, 0.89; 95 percent confidence interval, 0.81 to 0.97; P < 0.01).
“Among older adults initiating combination antihypertensive treatment, FDC therapy was associated with a significantly lower risk of composite clinical outcomes, which may be related to better medication adherence,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
Posted: September 2018
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