Evidence map›Paper›PMID 20026768›Full record

SynthesisHypertension (Dallas, Tex. : 1979)2010

Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis.

Ajay K Gupta, Shazia Arshad, Neil R Poulter

Registry-linked trialAbstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Hypertension (Dallas, Tex. : 1979), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03047538 (Fixed Combination for Lipid and Blood Pressure Control. Randomized Cross-over Study), which is not on this map. Cited by 236 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
236citing papers in PubMed, 18 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03047538 phase4withdrawnstarted 2017, after this paper: background citation

Fixed Combination for Lipid and Blood Pressure Control. Randomized Cross-over Study

Ran2017Enrolled0Registered outcomes5Posted comparisons0ConditionsArterial Hypertension, Blood Pressure, Dyslipidemias, Lipid Metabolism DisordersArmsAtorvastatin, Amlodipine, Perindopril
PMID 21205325PMID 24002278PMID 19339045PMID 22815989PMID 24707184PMID 20479948PMID 19125855PMID 18456100PMID 20653798PMID 21647425PMID 3946459other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

236 citing papers in PubMed, 18 syntheses or guidelines pooled it.

  1. Guideline
  2. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  3. Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Guideline
  10. Guideline
  11. Guideline
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Guideline
  16. Pooled it
  17. Fixed-dose combination therapy for the prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2014
    Pooled it
  18. Pooled it
  19. Trial
  20. Trial

176 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ajay K GuptaInternational Centre for Circulatory Health, Imperial College London, London, United Kingdom. A.K.Gupta@imperial.ac.uk
Shazia Arshad
Neil R Poulter

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Two or more antihypertensive agents are increasingly used to control blood pressure (BP) in hypertensive patients. However, it is unclear whether fixed-dose combinations (FDCs) of 2 antihypertensive agents in a single tablet provide greater benefits than the corresponding free-drug components given separately. A meta-analysis was performed to assess compliance, persistence, BP control, and safety associated with FDCs in comparison with their free-drug components. Fifteen included studies (n=32331) reported on >or=1 of the evaluated outcomes. In 3 cohort studies and 2 trials reporting on drug compliance (n=17 999), the use of FDCs was associated with significantly better compliance (odds ratio: 1.21 [95% CI: 1.03 to 1.43]; P=0.02) compared with its corresponding free-drug combinations. In 3 cohort studies (n=12 653), there was a nonsignificant improvement in persistence with therapy (odds ratio: 1.54 [95% CI: 0.95 to 2.49]; P=0.08), and in 5 trials (n=1775) the odds ratio for adverse effects for FDC use compared with free-drug combination use was 0.80 (95% CI: 0.58 to 1.11; P=0.19). In 9 trials (n=1671) with BP data, use of an FDC was associated with nonsignificant changes in systolic and diastolic BPs of 4.1 mm Hg (95% CI: -9.8 to 1.5; P=0.15) and 3.1 mm Hg (95% CI: -7.1 to 0.9; P=0.13), respectively. In these BP-lowering comparisons, there was heterogeneity associated with differences in study design but no publication bias. In conclusion, compared with free-drug combinations, FDCs of antihypertensive agents are associated with a significant improvement in compliance and with nonsignificant beneficial trends in BP and adverse effects.

Indexed as

Drug CombinationsAntihypertensive AgentsBlood Pressure DeterminationDose-Response Relationship, DrugDrug Administration ScheduleFemaleHumansHypertensionMalePatient CompliancePrognosisRandomized Controlled Trials as TopicSafety ManagementTreatment OutcomeAntihypertensive AgentsDrug Combinations

Identifiers

PMID20026768

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.