Most Read Articles
Roshini Claire Anthony, 11 Sep 2019

Beta-blockers could reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate or moderately-severe renal dysfunction without causing harm, according to the BB-META-HF* trial presented at ESC 2019.

Elvira Manzano, 4 days ago

The US Preventive Services Task Force (USPSTF), in an update of its 2013 recommendations, called on clinicians to offer risk-reducing medications to women who are at increased risk for breast cancer but at low risk for adverse effects.

Pearl Toh, 5 days ago
The use of SGLT-2* inhibitors was not associated with a higher risk of severe or nonsevere urinary tract infections (UTIs) in patients with type 2 diabetes (T2D) compared with DPP**-4 inhibitors or GLP-1*** receptor agonists, a population-based cohort study shows.
14 Sep 2019
In type 2 diabetes patients taking sulfonylureas, hypoglycaemia duration is longer at night and is inversely correlated with the level of glycated haemoglobin (HbA1c), a new study reports.

Triple superior to dual therapy in achieving BP goal

25 Jul 2019

Adding a third drug to achieve the target blood pressure (BP) seems to be more effective than increasing the dose of existing dual therapy without any increase in adverse events, suggest the results of a meta-analysis, adding that early use of triple therapy can help improve hypertension control.

The investigators searched publication databases, clinical trial registries and regulatory agency websites until April 2018 for double-blind randomized controlled trials (RCTs) comparing triple with dual therapy with BP-lowering drugs among hypertensive patients for at least 3 weeks.

Random effects model was used to conduct meta-analyses for efficacy and safety outcomes. Regimen efficacy was compared with observed efficacy and was predicted using the Therapeutic Intensity Score (TIS) and the Law et al method, which predict dose doubling increases efficacy by 100 percent and around 20 percent, respectively.

A total of 14 RCTs, including 11,457 participants, met the inclusion criteria. Compared with dual therapy, triple therapy lowered BP by 5.4/3.2 mm Hg (p<0.001) and improved BP control by 58 percent (vs 45 percent for dual therapy; relative risk [RR], 1.33, 95 percent CI, 1.25–1.41). Incidence of withdrawals due to adverse events were comparable (3.3 percent vs 3.4 percent; RR, 1.24, 1.00–1.54; p=0.05).

Law et al’s method was superior to TIS in predicting differences in efficacy between the two regimens. Furthermore, adding a third drug achieved on average about a fourfold reduction in BP compared with doubling the dose of dual therapy component drugs (6.0/3.6 vs 1.5/0.8 mm Hg) for patients uncontrolled on submaximal dose dual therapy.

“Most patients with hypertension need at least two drugs to achieve goal blood pressure,” the investigators noted.

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Most Read Articles
Roshini Claire Anthony, 11 Sep 2019

Beta-blockers could reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate or moderately-severe renal dysfunction without causing harm, according to the BB-META-HF* trial presented at ESC 2019.

Elvira Manzano, 4 days ago

The US Preventive Services Task Force (USPSTF), in an update of its 2013 recommendations, called on clinicians to offer risk-reducing medications to women who are at increased risk for breast cancer but at low risk for adverse effects.

Pearl Toh, 5 days ago
The use of SGLT-2* inhibitors was not associated with a higher risk of severe or nonsevere urinary tract infections (UTIs) in patients with type 2 diabetes (T2D) compared with DPP**-4 inhibitors or GLP-1*** receptor agonists, a population-based cohort study shows.
14 Sep 2019
In type 2 diabetes patients taking sulfonylureas, hypoglycaemia duration is longer at night and is inversely correlated with the level of glycated haemoglobin (HbA1c), a new study reports.