Study Finds Combination Blood Pressure Medications Equally Effective for South Asian Adults

A new study presented at the American Heart Association's Scientific Sessions 2024 reveals that various combinations of blood pressure-lowering medications in a single pill are equally effective for adults in India. The TOPSPIN trial, which included nearly 2,000 participants, tested three different two-drug combinations: amlodipine and perindopril, perindopril and indapamide, or amlodipine and indapamide.

Lead researcher Dr. Dorairaj Prabhakaran emphasized the importance of this study, noting that South Asians account for one-fourth of the global population, with India facing a significant burden of hypertension. The study's findings are particularly relevant given that high blood pressure affects 300 million people in India and nearly half of all U.S. adults.

After six months of treatment, approximately 70% of participants across all three groups achieved blood pressure levels below 140/90 mm Hg, with over 40% reaching the stricter target of less than 130/80 mm Hg. The absolute reduction in blood pressure was substantial, with office measurements showing a decrease of about 30/14 mm Hg and 24-hour ambulatory monitoring indicating a reduction of 14/8 mm Hg.

Importantly, all three combination pills demonstrated excellent safety profiles, with less than 3% of participants discontinuing treatment due to adverse effects. This high level of tolerability is crucial for long-term adherence to blood pressure management regimens.

The study's findings contradict previous research on Black adults in Sub-Saharan Africa, which found amlodipine-based combinations to be superior. This highlights the importance of population-specific research in developing effective hypertension treatments.

With more than five million South Asian people living in the U.S., these results have broad implications for hypertension management in this population. The study aligns with the American Heart Association's recommendation to simplify medication regimens for people with hypertension, such as through the use of combination pills.

As high blood pressure continues to be a significant global health concern, this research provides valuable insights into effective treatment strategies for a large and diverse population. The equal efficacy of different combination medications offers healthcare providers more flexibility in tailoring treatments to individual patient needs, potentially improving outcomes and reducing the risk of cardiovascular complications associated with hypertension.