That occasionally, very occasionally, quite effective results emerge from tinkering with existing drugs, and combinations thereof, is one of the reasons why people keep doing it, despite the fact that the overwhelming majority of the time the outcome is marginal at best. In the research here, a combination of existing blood pressure control drugs at lower doses is found to be considerably more effectively than any individual drug. Rising blood pressure with aging, hypertension, causes considerable damage through a variety of mechanisms to many organs, such as brain, heart, and kidney. Just as importantly, it accelerates the development of atherosclerosis to the point at which a vital blood vessel suffers catastrophic structural failure. Better control of blood pressure through pharmaceuticals is perhaps the most significant factor behind the reduced cardiovascular mortality of the past few decades, even though it has been achieved without addressing the fundamental cell and tissue damage that causes blood vessel stiffening and hypertension.
A small but clinically important trial of a new ultra-low dose four-in-one pill to treat high blood pressure has produced remarkable results. Every patient on the pilot trial saw their blood pressure levels drop to normal levels in just four weeks. Researchers said the results were exciting but larger trials were needed to see if these high rates could be maintained and repeated. "Most people receive one medicine at a normal dose but that only controls blood pressure about half the time. In this small trial blood pressure control was achieved for everyone. Trials will now test whether this can be repeated and maintained long-term. Minimising side effects is important for long-term treatments - we didn't see any issues in this trial, as you would hope with very low dose therapy, but this is the area where more long-term research is most needed. We know that high blood pressure is a precursor to stroke, diabetes and heart attack. The need for even lower blood pressure levels has been widely accepted in the last few years. So this could be an incredibly important step in helping to reduce the burden of disease globally."
Over four weeks 18 patients were either given a quadpill - a single capsule containing four of the most commonly used blood pressure-lowering drugs each at a quarter dose - or a placebo. This was then repeated for a further four weeks with the patients swapping their course of treatment. Blood pressure levels were measured hourly over a 24 hour period at the end of each treatment, allowing researchers to significantly reduce the amount of patients normally required in a clinical trial. 100 per cent of patients on trial saw their blood levels drop below 140 over 90. Just 33 per cent of patients on the placebo achieved this rate. None of the patients experienced side effects commonly associated with hypertension lowering drugs, which can vary from swollen ankles to kidney abnormalities depending on the type of class of the drug. "What makes these result every more exciting is that these four blood pressure medications are already in use. We are increasingly finding there are opportunities to treat many commons diseases hiding in plain sight. This ultimately means we will be able to deliver life changing medications much more quickly, and more affordably."