Taking single-pill combination medications (SPCMs), often referred to as fixed-dose combinations, helped adults lower their blood pressure (BP) faster and more effectively than those who took multiple medications separately, according to a December scientific statement from the American Heart Association published in Hypertension.
“Most people with high blood pressure need two or more blood pressure medications to reach target blood pressure measurements; however, taking multiple pills each day can be confusing or hard to keep up with,” said Jordan B. King, PharmD, MS, chair of the scientific statement writing group and an associate professor of population health sciences at the University of Utah in Salt Lake City. “Single-pill combination pills are valuable tools to manage high blood pressure. Individuals taking a single combination pill are able to achieve optimal blood pressure levels sooner than peers who take the same medications in separate pills.”
SPCMs work by packaging two or more active pharmaceutical ingredients in a single pill. Authors note that only about 25% of Americans have BP levels lower than 130/80 mm Hg and about 122 million American adults have high blood pressure (~50%). They analyzed various studies that have supported the efficacy of SPCMs, including SPRINT (Systolic Blood Pressure Intervention Trial), National Health and Nutrition Examination Survey, ACCOMPLISH trial (Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension) and more.
An analysis of a January 2021 research article found that SPCMs lead to meaningful improvements in BP control and were also associated with modest but statistically significant reductions in both systolic BP and diastolic BP at 12 weeks compared with free-pill combinations. However, the National Health and Nutrition Examination Survey showed that the prevalence of SPCM use also decreased from 35.8% in 2009 through 2012 to 27.8% in 2017 through 2020.
Authors also point out that there are also a multitude of barriers that prevent adults from taking SPCMs including knowledge gaps, insurance coverage and reimbursement policies, social determinants of health, prescriber attitudes and practices, as well as regulatory approval and commercial availability. They suggest that the greatest clinical benefits of SPCMs are likely realized when they are used to appropriately intensify therapy.