CLINICAL OUTCOMES OF MULTI-DRUG THERAPY VERSUS MONOTHERAPY IN HYPERTENSION MANAGEMENT
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Keywords
Hypertension, multi-drug therapy, monotherapy, blood pressure control, combination therapy, clinical outcomes
Abstract
Background: Hypertension remains a leading cause of cardiovascular morbidity and mortality worldwide. While monotherapy is often the initial approach, many patients require multiple antihypertensive agents to achieve blood pressure control.
Methods: A prospective cohort study was conducted involving 284 patients with essential hypertension recruited from two tertiary care hospitals. Patients were divided into two groups: monotherapy (n=142) receiving single antihypertensive agents and multi-drug therapy (n=142) receiving two or more agents. Primary outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood pressure control rates. Secondary outcomes included adverse events and quality of life scores.
Results: The multi-drug therapy group demonstrated significantly greater reductions in SBP (−28.4 ± 8.2 mmHg vs. −18.6 ± 7.4 mmHg, p<0.001) and DBP (−16.8 ± 5.6 mmHg vs. −10.2 ± 4.8 mmHg, p<0.001) compared to monotherapy. Blood pressure control (<140/90 mmHg) was achieved in 78.2% of multi-drug therapy patients versus 52.1% in monotherapy (p<0.001). Adverse events were comparable between groups (24.6% vs. 21.1%, p=0.486). Quality of life scores improved significantly in both groups, with no significant difference between them (p=0.124).
Conclusion: Multi-drug therapy demonstrated superior efficacy in blood pressure reduction and achieving target control compared to monotherapy, without a significant increase in adverse events. These findings support the use of combination therapy for patients requiring intensive blood pressure management.
References
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Dr. Shipra Sen
Assistant Professor, Department General Medicine, Rama Medical College, Kanpur, UP
