UK Edition
Two-in-one pill for blood pressure will 'save thousands of lives'
Switching millions of Britons to a “two in one” pill for blood pressure could save thousands of lives, experts say.
Around one in four adults in the UK are on multiple drugs for the condition, which is the biggest cause of heart disease and stroke.
But experts say only about half of those with high blood pressure are managing their illness properly - putting them at risk of deadly heart attacks.
Many are deterred by the fact they are put on a confusing cocktail of medications, with extra drugs often added when pressure becomes uncontrolled.
And often, GPs fail to put those at risk on sufficient medication experts say. Patients taking several drugs are four times more likely to miss a dose compared to those taking just one pill, research shows.
New guidelines from the European Society of Cardiology (ESC) say that instead, those with raised blood pressure should be put on “two-in-one” pills which are far more likely to be effective.
Speaking at the world’s largest cardiac conference, British experts said the shift could transform control of blood pressure - potentially saving thousands of lives.
Until now, GPs have been recommended to start off by putting patients on one drug, adding a second and a third if needed.
The authors of new medical guidance said that while at least 80 per cent of cases should have been upgraded to be on multiple medication, most were not - blaming “inertia” by doctors who were reluctant to change their strategies, despite a lack of success.
Professor Bryan Williams, from University College London, said: "The vast majority of patients with high blood pressure should start treatment with two drugs as a single pill.
"These pills are already available and should massively improve the success of treatment, with corresponding reductions in strokes, heart disease, and early deaths,” he said.
“This could lead the prevention of thousands more strokes and heart attacks per year,” said Prof Williams, one of the authors of the new guidelines.
High blood pressure is a major risk for heart attacks, stroke and heart failure, as well as a number of other diseases. It rarely causes symptoms. though those with very high blood pressure may have headaches, blurred or double vision, regular nosebleeds, difficulty breathing, chest pain, irregular heartbeat, blood in the urine, confusion, or pounding in the chest, neck, or ears.
NHS watchdog the National Institute for Health and Care Excellence is now looking at whether patients should be prescribed combination pills, with new advice expected next year.
Speaking at the ESC Congress in Munich, Professor Williams said two-in-one medication costs as little as five pence a day. But despite the benefits, few patients in the UK get them.
He added: “We have been using the same approach to lower blood pressure for the last 40 years and the improvements have been too slow and too many people are dying as a consequence.
“We have to do something more drastic. Using more combinations pills would definitely save lives.”
High blood pressure is known as the silent killer, because the symptoms often go unnoticed until it is too late. The new guidelines also suggest far more people should be put on the drugs.
Currently NHS advice is to put most people on the medication if their blood pressure exceeds 140mmHg/90 - meaning one in three adults are eligible for treatment.
But the new advice - which will now be considered by NHS watchdogs - suggests drugs should be offered to those with blood pressure which is significantly lower, at 130/85, for those below the age of 65.
It follows changes in advice from US cardiologists, which recommend medication even before this point.
Professor Metin Avkiran, associate medical director at the British Heart Foundation, said: “Around 40 per cent of people with high blood pressure are undiagnosed and many of those who are diagnosed aren’t managing their condition properly, even though we already have several effective medicines.
“The majority of people with high blood pressure have no symptoms, so part of the problem is that none of us like taking pills when we don't feel their benefit - and treatment becomes even more challenging when more than one pill is needed to control your blood pressure.
“The new guidelines suggest starting most patients with high blood pressure on a combination of two medicines in one pill. If adopted widely, this recommendation has the potential to improve effective blood pressure control and thus to reduce the risk of heart attacks and stroke."