Are all fixed dose combinations equally effective in blood pressure control? The analysis of four different fixed dose antihypertensive combinations

Objective: Hypertension guidelines recommend the use of fixed dose combinations as the first step treatment in patients with stage 2 and 3 hypertension. The aim of this study was to compare the antihypertensive effects of four different fixed-dose preparations containing beta blocker (BB)-diuretic, ACE inhibitor (ACEI)-diuretic, angiotensin receptor blocker (ARB)-diuretic, and calcium channel blocker (CCB)-ACEI.Methodology: Eighty patients with newly diagnosed hypertension whose sitting blood pressure (BP) ? 160/100 mmHg were randomized to receive either of those four fixed dose antihypertensive preparations: atenolol 50 mg-hydrochlorotiazide (HCTZ) 12.5 mg, or lisinopril 20 mg-HCTZ 12.5 mg, or telmisartan 80 mg-HCTZ 12.5 mg or verapamil 180 mg- trandolapril 2 mg. All the patients were followed up for six months.Results: Both systolic BP (SBP) and diastolic BP (DBP) were reduced similarly in all groups (45.7/22.4 mmHg in BB-diuretic group, 45.8/18.1 mmHg in ACEI-diuretic group, 54.6/17.6 mmHg in ARB-diuretic group and 38.9/16 mmHg in ACEI-CCB group. For SBP p=0.19 and for DBP p=0.43).Conclusion: All investigated fixed dose antihypertensive combinations were found similarly effective in reducing blood pressure