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See Latest ArticlesReview: combining 2 classes of blood pressure-lowering drugs has an approximately additive effect on systolic blood pressure
Evidence-Based Medicine, 10/08/09
Shantsila A et al. – Combining 2 classes of blood pressure–lowering drugs has an approximately additive effect on systolic blood pressure.
Methods- Medline, EMBASE/Excerpta Medica, and Cochrane Library (1966–Mar 2008); websites of industry and US Food and Drug Administration; and reference lists were searched for factorial, randomised placebo controlled trials.
- 42 RCTs (101 comparisons, {n = 10 854}*, mean age 46–71 y, duration 4–12 wks) met the selection criteria.
- 41 RCTs recruited outpatients from hospital hypertension clinics; 1 was done in a general practice setting. 26 trials had a parallel–group design, and 16 had a crossover design.
- Mean placebo–subtracted systolic BP reductions for monotherapies ranged from 6.8 mm Hg for ACE–Is to 9.3 mm Hg for BBs; reductions for drug combinations ranged from 13.9 mm Hg for ACE–I combinations to 18.9 mm Hg for BB combinations.
- Observed BP reductions for combination therapy were similar to that expected if the effects of monotherapies were additive.
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