Article Text

Download PDFPDF
Review: combining 2 classes of blood pressure–lowering drugs has an approximately additive effect on systolic blood pressure

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


What is the incremental effect of combination therapy using blood pressure (BP)–lowering drugs from 2 classes compared with monotherapy for reducing BP?

Review scope

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).

Review methods

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 …

View Full Text


  • Source of funding: no external funding. Dr N Wald and Dr M Law hold patents (EU1272220 and GB2361186) for a combination ‘polypill’ for prevention of cardiovascular disease. Dr D Wald also has an interest in its development.