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Position statement on use of pharmacological combinations in a single pill for treatment of hypertension by Argentine Federation of Cardiology (FAC) and Argentine Society of Hypertension (SAHA)

Journal of Human Hypertension volume 37, pages 438–448 (2023)Cite this article

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Abstract

The present document provides scientific evidence reviewed and analysed by a group of specialist clinicians in hypertension that aims to give an insight into a pharmacological strategy to improve blood pressure control. Evidence shows that most hypertensive patients will need at least two drugs to achieve blood pressure goals. There is ample evidence showing that treatment adherence is inversely related to the number of drugs taken. Observational studies show that use of drug combinations to initiate treatment reduces the time to reach the treatment goal and reduces CVD, especially with single pill combinations (SPCs). This work, based on recommendations of the Argentine Federation of Cardiology and Argentine Society of Hypertension as a reference, aims to review the more recent evidence on SPC, and to serve as guidelines for health professionals in their clinical practice and to the wider use of SPCs for the treatment of hypertension. Evidence from clinical trials on the effectiveness and adverse effects of using SPCs are provided. An analysis is also made of the main contributions of SPCs in special populations, e.g., elderly and diabetic patients, and its use in high risk and resistant hypertension. The effects of SPCs on hypertensive-mediated organ damage is also examined. Finally, we provide some aspects to consider when choosing treatments in the economic context of Latin-America for promoting the most efficient use of resources in a scarce environment and to provide quality information to decision makers to formulate safe, cost-effective, and patient-centered health policies. Finally, future perspectives and limitations in clinical practice are also discussed.

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Fig. 1: Advantages of FDC over free combinations.

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Authors and Affiliations

  1. Unit of Hypertension, Hospital Español de Mendoza. School of Medicine. National University of Cuyo. IMBECU-CONICET, Mendoza, Argentina

    Nicolás Renna

  2. Sanatorio Británico Cardiology Institute, Rosario, Argentina

    Daniel Piskorz

  3. Instituto de Cardiología, San Miguel de Tucumán, Tucumán, Argentina

    Diego Stisman

  4. National University of Cordoba, Cordoba, Argentina

    Diego Martinez

  5. Servicio de Cardiología Hospital San Bernardo, Salta, Argentina

    Ludmila Lescano

  6. Centro de neurología y rehabilitación-CENYR, San Luis, Argentina

    Sergio Vissani

  7. Hospital San Martin, La Plata, Buenos Aires, Argentina

    Walter Espeche

  8. Servicio de Nefrología Hospital San Bernardo, Salta, Argentina

    Diego Marquez

  9. Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina

    Roberto Parodi

  10. Instituto Especialidades de la Salud Rosario, Santa Fe, Argentina

    Diego Naninni

  11. Instituto Modelo de Cardiologia, Cordoba, Argentina

    Marcos Baroni

  12. Consultorio de Cardiología Clínica e Hipertensión Arterial en CEDIT / Clínica Chapelco y Centro Médico Roca, San Martìn de los Andes, Neuquèn, Argentina

    Daniel Llanos

  13. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Rocio Martinez & Jessica Barochinner

  14. Unidad de Hipertensión Arterial, Grupo Oroño, Rosario, Argentina

    Gustavo Staffieri

  15. Departamento de Medicina Interna y CIGES, Universidad de La Frontera, Temuco, Chile

    Fernando Lanas

  16. Departamento de Especialidades Médicas. CIGES, Universidad de La Frontera, Temuco, Chile

    Mónica Velásquez

  17. Hospital Italiano Ctro. Agustín Rocca-San Justo (HICAR), Buenos Aires, Argentina

    Marcos Marin

  18. Institute of Cardiovascular Sciences and NIHR University College London Hospitals Biomedical Research Centre, University College London, London, UK

    Bryan Williams

  19. Centro de Investigaciones Cardiovasculares, Facultad de Ciencias Médicas, UNLP-CONICET, La Plata, Argentina

    Irene Ennis

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Renna, N., Piskorz, D., Stisman, D. et al. Position statement on use of pharmacological combinations in a single pill for treatment of hypertension by Argentine Federation of Cardiology (FAC) and Argentine Society of Hypertension (SAHA). J Hum Hypertens 37, 438–448 (2023). https://doi.org/10.1038/s41371-021-00557-w

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