GPs have been criticised by a leading adviser for their resistance to switch to more intense drug treatments for patients with hypertension.
After a joint review with the British Hypertension Society, NICE has now provided new guidelines advising that hypertension could be managed through combination therapies and an increase in fixed-dose combinations.
The safety of combination therapy was also presented by the ACCELERATE trial at the Hypertension 2010 meeting held in Vancouver this week.
Professor Peter Sever, professor of clinical pharmacology at Imperial College London and a member of the BHS guidelines working party, said the joint guidance would look to ramp up hypertension management.
He said: "There's still appalling levels of blood-pressure control. Combinations would address compliance, particularly if given in the same pill."
Researchers led by several members of the BHS guidelines working party randomised 1,250 patients to aliskiren 150mg and amlodipine 5mg, either in combination or alone.
They discovered that mean blood pressure fell over 24 weeks by 6.4mmHg systolic and 3.7mmHg diastolic more in patients on combinations than sequential therapies.
Copyright © Press Association 2010
Your comments (terms and conditions apply):
"I'm on amlodipine, 10mg and want to get the dose I'm taking down because of the frightening side effects and I have been trying to educate myself, despite my chemobrain, on the different categories of BP drugs so I could be knowledgeable to speak with my doctor. Sometimes it seems I need the dose lowered because of low BP readings while feeling 'faint' but then I have a fight with my husband and my systolic goes way up so I'm scared I'll have a stroke. I had no testing before I went on a CCB so from my reading I wonder if even I'm taking the correct class. Being of the category of human being that processes and deals with emotion, mine and other people's, which was very useful when I was working professionally, I feel defeated by this whole blood pressure/drugs arena and so far have been unable to find good clear information about the different drugs" – Name and address withheld