HypertensionRandomised controlled trial
Quadruple vs triple therapy for resistant hypertension: the QUADRO trial
- Randomised controlled trial
- multicentre
- Phase 3
- double-blind
Authors' conclusion
The first full-dose quadruple antihypertensive SPC (perindopril/indapamide/amlodipine/bisoprolol) demonstrated superiority over perindopril/indapamide/amlodipine, offering an effective alternative therapy for confirmed resistant hypertension.
Study context
- Population
- Resistant hypertension with uncontrolled blood pressure (BP) after 8-week run-in on perindopril/indapamide/amlodipinerandomised 1:1
- Participants
- 183 participants
- Comparison
- Quadruple single-pill combination (SPC) vs continued triple therapy
- Quadruple SPCn = 89
- Triple therapyn = 94reference
- Primary endpoint
- Office SBP
- Follow-up
- Week 8
Primary result
Decrease in office SBP · 8 weeks
Difference
−8 mmHg
95% CI −11.99 to −4.09
P < 0.0001
Quadruple SPC vs Triple therapy
difference −8 mmHg (95% CI −11.99 to −4.09); P < 0.0001
As reported in the abstract
Further findings
| Outcome | difference (mmHg) (95% CI) | P value | |
|---|---|---|---|
| 24 h ambulatory BP (ABPM) · 8 weeks · greater decrease with quadruple SPC | −8 (−10.95 to −4.11) | P < 0.0001 | |
| −15−10−505Difference, mmHg (linear scale) |
Safety
≥1 treatment-emergent adverse event (TEAE) · 8 weeks
≥1 treatment-emergent adverse event (TEAE) · 8 weeks
- No serious or severe TEAEs reported
- Both treatments well tolerated
Original publication
Quadruple vs triple therapy for resistant hypertension: the QUADRO trial. Eur Heart J. Published 11 February 2026. doi:10.1093/eurheartj/ehag022
Summarised from the published abstract; every number is checked against it