Are all fixed dose combinations equally effective in blood pressure control? the analysis of four different fixed dose antihypertensive combinations

ABSTRACT

Hypertension guidelines recommend the use of fixed dose combinations as the first step treatment in patients with stage 2 and 3 hypertension. The aim of this study was to compare the antihypertensive effects of four different fixed-dose preparations containing beta blocker [BB]-diuretic, ACE inhibitor [ACEI]-diuretic, angiotensin receptor blocker [ARB]-diuretic, and calcium channel blocker [CCB]-ACEI. Eighty patients with newly diagnosed hypertension whose sitting blood pressure [BP] >/= 160/100 mmHg were randomized to receive either of those four fixed dose antihypertensive preparations atenolol 50 mg-hydrochlorotiazide [HCTZ] 12.5 mg, or lisinopril 20 mg-HCTZ 12.5 mg, or telmisartan 80 mg-HCTZ 12.5 mg or verapamil 180 mg- trandolapril 2 mg. All the patients were followed up for six months. Both systolic BP [SBP] and diastolic BP [DBP] were reduced similarly in all groups [45.7/22.4 mmHg in BB-diuretic group, 45.8/18.1 mmHg in ACEI-diuretic group, 54.6/17.6 mmHg in ARB-diuretic group and 38.9/16 mmHg in ACEI-CCB group. For SBP p=0.19 and for DBP p=0.43]. All investigated fixed dose antihypertensive combinations were found similarly effective in reducing blood pressure