Low-Dose Triple-Pill vs Standard-Care Protocols for Hypertension Treatment in Nigeria: A Randomized Clinical Trial
Primary result · Reduction in home mean SBPResult — go to the resultAdjusted difference −5.8 mm Hg 95% CI −8.0 to −3.6Authors' 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
| Outcome | Triple-pill | Standard-care | Risk difference (95% CI) | |
|---|---|---|---|---|
| Clinic BP control (<140/90 mm Hg) · month 6 | 82% | 72% | 10% (−2% to 20%) | |
| Home BP control (<130/80 mm Hg) · month 6 | 62% | 28% | 33% (22%–44%) | |
| −200204060Difference (linear scale) |
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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