OTHER
Therapeutics
Review: combining 2 classes of blood pressure–lowering drugs has an approximately additive effect on systolic blood pressure
| The first 150 words of the full text of this article appear below. |
What is the incremental effect of combination therapy using blood pressure (BP)–lowering drugs from 2 classes compared with monotherapy for reducing BP?
Included studies compared combinations of BP-lowering drugs from 2 of 4 classes (thiazides, β blockers [BBs], angiotensin-converting enzyme inhibitors [ACE-Is], and calcium-channel blockers [CCBs]) with each drug alone and with placebo and were 
2 weeks in duration. Trials with a non-randomised order of treatment and placebo were excluded. Outcome was mean placebo-subtracted systolic BP reduction (difference in BP reduction between treatment and placebo groups).
Medline, EMBASE/Excerpta Medica, and Cochrane Library (1966–Mar 2008); websites of industry and US Food and Drug Administration; and reference lists were searched for factorial, randomised placebo controlled trials (RCTs). 42 RCTs (101 comparisons, {n = 10 854}*, mean age 46–71 y, duration 4–12 wks) met the selection criteria. 41 RCTs recruited outpatients from hospital hypertension clinics; 1 was done in a general practice
City Hospital, Birmingham, UK
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Hypertension
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Drugs: cardiovascular system
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Drugs: musculoskeletal and joint diseases
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