Fixed Low-Dose Triple Combination Antihypertensive Medication vs Usual Care for Blood Pressure Control in Patients With Mild to Moderate Hypertension in Sri Lanka A Randomized Clinical Trial
Fixed Low-Dose Triple Combination Antihypertensive Medication vs Usual Care for Blood Pressure Control in Patients With Mild to Moderate Hypertension in Sri Lanka A Randomized Clinical Trial
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DOI：
10.1001/jama.2018.10359
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发表时间：
2018-08-14
影响因子：
120.7
通讯作者：
Patel, Anushka
中科院分区：
文献类型：
--
作者：
Webster, Ruth;Salam, Abdul;Patel, Anushka
控制不良的高血压是一个主要的全球公共卫生问题，需要新的治疗策略。目的评价低剂量三联抗高血压药物与常规治疗相比是否能更好地控制血压。设计、环境和参与者：对需要开始（未经治疗的患者）或升级（接受单一治疗的患者）降压治疗的高血压成人（收缩压>140 mm Hg和/或舒张压>90 mm Hg；或糖尿病或慢性肾病患者：>130 mm Hg和/或>80 mm Hg）进行低剂量三倍降压治疗与常规治疗的随机、开放标签试验。2016年2月至2017年5月，患者从斯里兰卡的11家城市医院诊所入组；随访于2017年10月结束。干预措施每日一次固定剂量三联片（替米沙坦20mg，氨氯地平2.5 mg，氯噻酮12.5 mg）治疗（n = 349）或常规护理（n = 351）。主要结局和测量主要结局是达到目标收缩压/舒张压的比例(
IMPORTANCE Poorly controlled hypertension is a leading global public health problem requiring new treatment strategies.OBJECTIVE To assess whether a low-dose triple combination antihypertensive medication would achieve better blood pressure (BP) control vs usual care.DESIGN, SETTING, AND PARTICIPANTS Randomized, open-label trial of a low-dose triple BP therapy vs usual care for adults with hypertension (systolic BP >140 mm Hg and/or diastolic BP >90 mm Hg; or in patients with diabetes or chronic kidney disease: >130 mm Hg and/or >80 mm Hg) requiring initiation (untreated patients) or escalation (patients receiving monotherapy) of antihypertensive therapy. Patients were enrolled from 11 urban hospital clinics in Sri Lanka from February 2016 to May 2017; follow-up ended in October 2017.INTERVENTIONS A once-daily fixed-dose triple combination pill (20 mg of telmisartan, 2.5 mg of amlodipine, and 12.5 mg of chlorthalidone) therapy (n = 349) or usual care (n = 351).MAIN OUTCOMES AND MEASURES The primary outcome was the proportion achieving target systolic/diastolic BP (