Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina.
Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2023;83(4):603-611.
Recommendations and guidelines propose to combine antihypertensive drugs to improve BP control, highlighting the advantages of single-pill combinations (SPCs) to improve treatment adherence. It is speculated that, compared with free-dose combinations (Free-DCs), SPC should achieve a reduction in cardiovascular (CV) events and mortality through better adherence and BP control. However, there is little information in this regard. For this reason, the objective of this review was to provide a descriptive analysis the differences in CV outcomes between SPCs antihypertensive drugs treatments vs. Free-DCs treatments. Ten studies were found and none had a randomized controlled design. Medication adherence was higher with SPCs, but outcomes were not adjusted for the adherence / persistence. When groups were compared according to similar adherence degrees, the statistical significance in favor of SPCs disappeared. Thus, randomized controlled studies are necessary to evaluate if SPCs have any effect beyond the improvement of the adherence to hypertensive treatment.
建议和指南提出联合使用降压药物以改善血压控制，强调了单片复方制剂（SPC）改善治疗依从性的优势。据推测，与自由剂量组合（Free-DC）相比，SPC 应通过更好的依从性和血压控制来降低心血管（CV）事件和死亡率。然而，这方面的信息很少。出于这个原因，本综述的目的是提供一个描述性分析，比较 SPC 降压药物治疗与 Free-DC 治疗在 CV 结局方面的差异。共发现 10 项研究，但没有一项是随机对照设计。SPC 的药物依从性更高，但结果并未根据依从性/持久性进行调整。当根据相似的依从性程度对组进行比较时，SPC 有利的统计学意义消失了。因此，需要进行随机对照研究来评估 SPC 是否除了改善高血压治疗的依从性之外还有任何效果。
