Sydney, Australia—A preliminary trial for a new 4-in-1 pill to treat hypertension has shown promising results.

The study published recently in The Lancet reports that high blood pressure dropped to normal in just 4 weeks for every patient involved in the trial conducted by The George Institute for Global Health

Although the trial involved only 18 patients, study authors also performed a systematic review of past trials, including 36 trials with 47,500 patients testing single and dual quarter-dose therapy. The previous evidence also indicated few or no side effects with very low doses, and important benefits with three or four drug combinations, they report.

“Most people receive one medicine at a normal dose but that only controls blood pressure about half the time. In this small trial blood pressure control was achieved for everyone,” explained Clara Chow, MBBS, PhD, director of the Cardiovascular Division at The George Institute, which is associated with the University of Sydney. Trials will now test whether that can be repeated and maintained long-term.

“Minimizing side effects is important for long-term treatments—we didn’t see any issues in this trial, as you would hope with very low dose therapy, but this is the area where more long-term research is most needed,” she added. “We know that high blood pressure is a precursor to stroke, diabetes, and heart attack. The need for even lower blood pressure levels has been widely accepted in the last few years. So this could be an incredibly important step in helping to reduce the burden of disease globally.”

Over 4 weeks, 18 patients in Sydney, average age of 58, were either given a quadpill—a single capsule containing four blood pressure-lowering drugs each at quarter-dose (irbesartan 37.5 mg, amlodipine 1.25 mg, hydrochlorothiazide 6.25 mg, and atenolol 12.5 mg)—or a placebo. The trial was then repeated for a further 4 weeks with the patients swapping their courses of treatment.

Blood pressure levels were measured hourly over a 24-hour period at the end of each treatment, allowing researchers to significantly reduce the amount of patients normally required in a clinical trial.

Results indicate that 100% of patients in the trial had blood pressure drop below 140 over 90, compared to 33% of the patients on placebo. In addition, none of the patients experienced side effects commonly associated with hypertension-lowering drugs, which can vary from swollen ankles to kidney abnormalities, depending on the type of class of the drug.

“What makes these results even more exciting is that these four blood pressure medications are already in use,” Chow pointed out. “We are increasingly finding there are opportunities to treat many common diseases hiding in plain sight. This ultimately means we will be able to deliver life-changing medications much more quickly, and more affordably.”

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