Combined hypertension drug recommended

A study published in The Lancet has recommended a combination of two drugs for the treatment of high blood pressure.

The research, funded by Novartis, investigated a combination of the renin inhibitor aliskiren and the calcium channel blocker amlodipine in the early control of high blood pressure in comparison with each drug used on its own.

Aliskiren is marketed by Novartis as Tekturna in the US, and as Rasilez elsewhere. Amlodipine was developed and commercialised as Norvasc by Pfizer, although its patent expired in 2007. The combination drug, which was approved by the US Food and Drug Administration (FDA) in 2010, is marketed by Novartis as Tekamlo.

Over 1,200 participants with essential hypertension – defined as high blood pressure with no identifiable cause – were involved in the study, with trials spread over ten countries.

Initially, around half of the people involved in the trial were given the combination therapy, while the remaining participants was split into two further groups each taking an individual therapy plus placebo. All individuals were then switched to the combination therapy at 16 weeks.

Results showed that patients originally given the combination treatment had a 6.5mm Hg increased reduction in mean systolic blood pressure - the maximum pressure exerted when the heart contracts, pushing blood into the arteries.

Associate medical director for the British Heart Foundation, Professor Jeremy Pearson, commented on the results: "This study adds significantly to the evidence that starting treatment for patients with high blood pressure with two medicines rather than one is safe, and more effective than waiting to add the second medicine later.

"Good control of blood pressure is still hard to achieve in many patients. So we are currently funding follow-up trials to this research that will find out the best way to treat patients whose hypertension is still poorly controlled with two drugs, and who need extra medicines."

The Lancet has the study available to subscribers.