A study on determining the best combination of medicines to manage hypertension or high blood pressure in India has finally ended.

The study was conducted by doctors from the All India Institute of Medical Sciences (AIIMS), Imperial College London, experts from the NGO Center for Chronic Disease Control and other organizations in India.

The clinical trial, called TOPSPIN (Treatment Optimization for Blood Pressure with Single-Pill Combination in India), aims to fill a major gap in international guidelines, which currently do not specify which drug combination should be used by Indians. Works best for.

The trial examined three commonly used two-drug combinations (also known as single-pill combinations or SPCs) of antihypertensive medications:

• amlodipine/perindopril
• Perindopril/Indapamide
• Amlodipine/Indapamide

Why this combination?

According to existing global studies, these combinations were chosen because they are effective in reducing blood pressure and the risk of cardiovascular complications.

Using single-pill combinations rather than single drugs has several benefits, including faster and better blood pressure control, fewer side effects, and simpler dosing, which improves patient adherence.

The trial uses a robust randomized, single-blind methodology to ensure fair and unbiased results. This includes patients from different parts of India who are either not taking any blood pressure medicine or taking only one. This approach ensures that the findings will be applicable to most Indian patients.

Initially, the medicines were given in low doses, with the dose gradually increased after two months. By month six, all participants had received their full dose of their prescribed combination, allowing comprehensive comparisons.

Study Challenges

The study was not without obstacles. Recruiting participants was difficult because most patients with mild hypertension are treated in small clinics, not the large hospitals where research is usually conducted.

In addition, for logistical reasons only specific drug combinations were tested, leaving out options such as beta-blockers, a class of prescription drugs treating conditions such as heart conditions, high blood pressure and anxiety.

Another limitation was that due to funding constraints the study focused on blood pressure reduction and not long-term heart health outcomes.

This is the first study to test these drug combinations specifically for Indian patients, who often have unique health needs compared to populations elsewhere.

With participants aged between 30 to 79 years and a good representation of women, the trial findings are expected to guide better treatment strategies for Indians and even the broader South Asian community around the world.

Once completed, this research could reshape how hypertension is managed in India, potentially improving the lives of millions of people.