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One Pill to Rule Them All: The Role of Single-Pill Combinations in Optimizing Blood Pressure Control

Kelsey B Bryant1, Benjamin D Gallagher2, Jennifer L Cluett3

  • 1Department of Medicine, Icahn School of Medicine, Mount Sinai, 17 E 102nd St, D6-153, New York, NY, 10029, USA. kelsey.bryant@mountsinai.org.

Journal of General Internal Medicine
|July 7, 2026
PubMed

Insights

Single-pill combinations (SPCs) improve medication adherence and reduce cardiovascular events in hypertension. Implementing these combination therapies in primary care is crucial for better blood pressure control.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Hypertension control in the U.S. is suboptimal, leading to preventable cardiovascular events.
  • Single-pill combinations (SPCs) improve adherence and outcomes in other chronic diseases but are underused in hypertension.
  • The latest AHA/ACC guideline recommends SPCs for stage 2 hypertension.

Purpose of the Study:

  • To review evidence supporting SPC use in hypertension.
  • To identify implementation challenges for SPCs in primary care.
  • To highlight strategies and evidence gaps for integrating SPCs into routine care.

Main Methods:

  • Review of existing evidence on SPC efficacy and adherence.
  • Analysis of barriers to SPC implementation in clinical practice.
  • Discussion of strategies for overcoming implementation challenges.

Main Results:

  • SPCs offer improved adherence and reduced cardiovascular events and mortality.
  • Clinical practice faces challenges in SPC adoption, including agent selection, cost, and workflow.
  • Evidence gaps exist in long-term management and population-level control strategies.

Conclusions:

  • SPCs are recommended for stage 2 hypertension, but uptake is limited.
  • Addressing implementation barriers is key to utilizing SPCs effectively.
  • Further strategies are needed to integrate SPCs for population-level blood pressure control.

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