Hypertension

Low-Dose Triple-Pill vs Standard-Care Protocols for Hypertension Treatment in Nigeria: A Randomized Clinical Trial

JAMAPublished Randomised controlled trial

Primary result · Reduction in home mean SBPResult — go to the resultAdjusted difference −5.8 mm Hg 95% CI −8.0 to −3.6

Authors' conclusion

Among Black African adults with uncontrolled hypertension, a low-dose triple-pill protocol achieved better blood pressure lowering and control with good tolerability compared with the standard-care protocol.

Study context

Population
Black African adults with uncontrolled hypertension (≥140/90 mm Hg), untreated or on a single BP-lowering drug, family medicine clinics in Nigeria273 (91%) completed
Participants
300 adults
Comparison
Low-dose triple-pill protocol vs standard-care protocol
Primary endpoint
Reduction in home mean SBP (effectiveness); discontinuation due to adverse events (safety)
Follow-up
Randomization to month 6
Methodological detailsparallel-group, open-label, multicentre
  • Parallel-group
  • Open-label
  • Multicentre

Primary result

Reduction in home mean SBP · month 6

Adjusted difference

−5.8 mm Hg

95% CI −8.0 to −3.6

P < 0.001

Change by group

Triple-pill

31

mean reduction · 95% CI 28–33 · mm Hg

Standard-care

26

mean reduction · 95% CI 22–28 · mm Hg

Triple-pillvs Standard-care
adjusted difference −5.8 mm Hg (95% CI −8.0 to −3.6); P < 0.001

As reported in the abstract

Further findings

OutcomeTriple-pillStandard-careRisk difference (95% CI)
Clinic BP control (<140/90 mm Hg) · month 682%72%10% (−2% to 20%)
Home BP control (<130/80 mm Hg) · month 662%28%33% (22%–44%)

Safety

Discontinuation of trial treatment due to adverse events (primary safety outcome)

No participants discontinued trial treatment due to adverse events

Original publication

Low-Dose Triple-Pill vs Standard-Care Protocols for Hypertension Treatment in Nigeria: A Randomized Clinical Trial. JAMA. Published 1 October 2024. doi:10.1001/jama.2024.18080

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