A triple pill protocol to reduce blood pressure (BP) among Nigerian patients with hypertension yielded excellent efficacy results and a good safety profile, demonstrating that a simple treatment protocol can strongly improve the current standard-of-care for this population.
The investigator-initiated VERONICA-Nigeria trial randomly assigned 300 self-identified Black African adults with uncontrolled hypertension 1:1 to a triple pill-based treatment protocol or to the standard-of-care Nigerian hypertension treatment protocol, which starts with one agent and may be changed to two agents if the result is insufficient. Prof. Dike Ojji, MB, BS, PhD, from the University of Abuja, in Nigeria, and colleagues looked at the change in home-measured systolic BP at 6 months.
After 6 months of treatment, participants in the triple pill group had an average 5.8 mmHg lower systolic BP than those in the standard-of-care group. For diastolic BP, the corresponding number was 3.6 mmHg. Furthermore, 62% of the participants in the experimental arm versus 28% of those in the control arm had achieved a BP less than 130/80 (P<0.001).
“No patients in either study arm had discontinued treatment due to AEs,” continued Dr. Ojji. “The only safety issue we noticed was a slight increase in hypo-potassium (<3.5 mmol/L) in the triple pill arm (34% vs 18%).” When the researchers looked at participants with a potassium level <3.0 mmol/L, they noticed that the proportion had dropped from 34% to 9% in the experimental arm.
In conclusion, the triple pill protocol was more effective than the standard-of-care BP protocol in lowering BP in Black African patients. The BP control rate at 1 month was 80%, which was maintained throughout the study.
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