Use of a combination antihypertensive product containing quarter doses of four different drugs could be an effective strategy to get patients to target blood pressures in one step, a new study suggests.
The study, QUARTET-USA, showed a reduction in blood pressure of almost 5 mm Hg more than the comparator of one antihypertensive agent at standard dose over the 12-week follow up period in patients with mild to moderate hypertension.
The QUARTET-USA study was presented at the American Heart Association (AHA) Scientific Sessions 2022 by Mark Huffman, MD, professor of medicine at Washington University School of Medicine, St Louis, Missouri.
It builds on a previous trial, QUARTET, conducted in Australia, which first showed benefits with this approach.
In the new US study, which was considerably smaller than the Australian trial, the four-drug combination, including candesartan, amlodipine, indapamide, and bisoprolol, led to a -4.8/-4.9 mm Hg greater reduction in blood pressure from baseline to 12 weeks compared with standard-dose candesartan monotherapy.
Differences in systolic blood pressure were not statistically significant, which is likely because of limited power related to the sample size, Huffman noted.
Adverse events were more common in the four-drug intervention group, but the rate of discontinuation was higher in the comparator group.
