Related Experiment Video
Updated: Aug 24, 2025
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
The Effects of Single Pill Combinations on Adherence and Blood Pressure Control in Hypertensive Patients
Nabil Naser1,2, Zaim Jatic1,2, Sevleta Avdic1
1Polyclinic "Dr. Nabil", Sarajevo, Bosnia and Herzegovina.
Insights
Single pill combination (SPC) therapy significantly improves blood pressure control and adherence in hypertensive patients compared to free combination (FC) therapy. SPC offers a more effective and convenient approach to managing hypertension.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypertension is a primary risk factor for cardiovascular disease, with suboptimal blood pressure control rates globally.
- Adherence to antihypertensive medication is poor, with a significant percentage of patients discontinuing treatment within a year.
Purpose of the Study:
- To compare the efficacy of single pill combination (SPC) antihypertensive drugs versus free combination (FC) therapy.
- To evaluate the impact of SPC on treatment adherence, blood pressure control, and cardiovascular events.
Main Methods:
- A study involving 192 adult hypertensive patients (age ≤ 79) with uncontrolled hypertension was conducted.
- Patients were randomized into two groups: SPC therapy and standard FC therapy, matched for age and gender.
Main Results:
- SPC therapy demonstrated significantly greater reductions in systolic and diastolic blood pressure at 6 months compared to FC therapy (SBP: 21.9 vs. 13.1 mmHg; DBP: 13.7 vs. 8.0 mmHg).
- Adherence rates were substantially higher in the SPC group (84.2%) versus the FC group (52%).
- Target blood pressure levels (<130/80 mmHg) were achieved by a larger proportion of patients on SPC (78.2%) compared to FC (46.3%).
Conclusions:
- Single pill combinations represent an emerging best practice for hypertension management.
- SPC therapy enhances adherence, affordability, and convenience, leading to improved blood pressure control and potentially reduced cardiovascular events.
Background:
Hypertension is the most important risk factor for cardiovascular morbidity and mortality. Blood pressure control rates are as low as 17% to 31% in patients diagnosed with hypertension in high-income countries; control rates are likely poorer in low- to middle- and low-income countries. Blood pressure control rates are as low as 17% to 31% in patients diagnosed with hypertension in high-income countries; control rates are likely poorer in low- to middle- and low- income countries. Overall, 43% to 66% of patients fail to adhere to their prescribed antihypertensive medications, and after 1 year, ≈40% of patients with hypertension may stop their initial drug treatment.
Objective:
The aim of the study was to evaluate the effects of single pill combination antihypertensive drugs on the adherence to treatment, blood pressure control and cardiovascular events vs. free-combination therapy.
Methods:
We enrolled 192 adult hypertensive patients not older than 79 years, with untreated or uncontrolled hypertension despite previously receiving free combination antihypertensive therapy, between November 2020 and March 2022. Patients treated with single pill combination (SPC) were compared with an arm of the same size (n = 96) and matched by age and gender who received a standard free combination (FC) antihypertensive therapy.
Results:
There were significant reductions from baseline to month 6 of follow-up in office SBP in the SPC group vs. reduction in FC group (21.9 vs. 13.1 mmHg; p < 0.0001). There were significant reductions from baseline to month 6 of follow-up in office DBP in the SPC group vs. group with free-combination therapy (13.7 vs. 8.0 mmHg; p < 0.0001). At 6 months, 94 participants (98%) were still prescribed the SPC therapy. At the final 6-month study visit, 84.2% of patients in the SPC therapy group were adherent to the prescribed antihypertensive therapy vs. 52% of patients in the FC group. Target BP values (mean 24h ambulatory systolic/diastolic BP < 130/80 mmHg) were reached by more recipients of SPC than free-combination therapy (78.2% vs. 46.3%, p < 0.05) at month 6 of follow-up.
Conclusion:
Treatment with single pill combinations (SPC), is the emerging best practice for safe, effective, rapid, and convenient hypertension control. It improves the affordability, adherence and control of arterial hypertension.
Related Concept Videos
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
01:23Hypertension V: Nursing Management
01:28Factors affecting Blood pressure
Physiological Factors:
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:18Hypertension and Regulation of Blood Pressure