Evidence map›Paper›PMID 37902939›Full record

SynthesisClinical drug investigation2023

The Safety and Efficacy of Quadruple Ultra-Low-Dose Combination (Quadpill) for Hypertension Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Mohamed Abuelazm, Shafaqat Ali, Othman Saleh, Amr Badr, Obieda Altobaishat, Majd M AlBarakat, Aya Aboutaleb, Abdelmonem Siddiq, Basel Abdelazeem

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical drug investigation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
0.9field-weighted citation impact, top 23% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Low-Dose Triple-Pill of Telmisartan, Amlodipine, and Indapamide for Initial Hypertension Treatment: A GRADE-Assessed Meta-analysis of Randomized Trials.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Pooled it
  2. Pooled it
  3. Guideline
  4. Review
  5. Article
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

9 authors at 8 institutions in 3 countries.

Mohamed AbuelazmFaculty of Medicine, Tanta University, Tanta, Egypt.
Shafaqat AliDepartment of Internal Medicine, Louisiana State University, Shreveport, LA, USA.
Othman SalehFaculty of Medicine, The Hashemite University, Zarqa, Jordan.
Amr BadrDepartment of Cardiology, Benha Teaching Hospital, Benha, Egypt.
Obieda AltobaishatFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Majd M AlBarakatFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Aya AboutalebFaculty of Medicine, Zagazig University, Shaibet an Nakareyah, Zagazig, 44519, Ash Sharqia Governorate, Egypt. Ayam78801@gmail.com.ORCID http://orcid.org/0000-0001-6979-9867
Abdelmonem SiddiqFaculty of Pharmacy, Mansoura University, Mansoura, Egypt.
Basel AbdelazeemDepartment of Cardiology, West Virginia University, Morgantown, West Virginia, United States.
Jordan University of Science and Technology · JOBenha University · EGHashemite University · JOLouisiana State University in Shreveport · USMansoura University · EGTanta University · EGWest Virginia University · USZagazig University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveQuadpill, a single pill containing a quadruple combination of quarter doses of four antihypertensive agents, has been investigated for hypertension treatment. This meta-analysis aims to evaluate the safety and efficacy of quadpill for hypertension management.

methodsWe conducted a systematic review and meta-analysis synthesizing randomized controlled trials evaluating quadpill versus monotherapy or placebo in patients with hypertension, which were retrieved by systematically searching PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane through 17 February, 2023. Continuous and dichotomous outcomes were pooled using mean difference (MD) and risk ratio (RR) along with confidence interval (CI), using Revman Version 5.4 software. Our protocol has been published in PROSPERO with ID: CRD42023406527.

resultsFour randomized controlled trials with a total of 779 patients were included in our analysis. Quadpill was effective in controlling systolic blood pressure in the short term [4-6 weeks] (RR: - 13.00 with 95% CI [- 17.22, - 8.78], p = 0.00001) and in the long term [12 weeks] (RR: - 6.18 with 95% CI [- 9.35, - 3.01], p = 0.0001). Quadpill was also effective in controlling automated diastolic blood pressure in the short term [4-6 weeks] (MD: - 8.15 with 95% CI [- 9.42, - 6.89], p = 0.00001) and in the long term [12 weeks] (MD: - 6.35 with 95% CI [- 10.37, - 2.33], p = 0.002). Moreover, patients in the quadpill group significantly achieved target blood pressure <140/90 (RR: 1.77 with 95% CI [1.26, 2.51], p = 0.001) compared with the control group.

conclusionsThe quadruple ultra-low-dose combination of antihypertensive drugs (quadpill) was effective and safe for hypertension treatment. However, further large-scale, multicenter, randomized controlled trials are still warranted before endorsement in clinical practice.

Indexed as

HypertensionAntihypertensive AgentsBlood PressureHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicAntihypertensive Agents

Identifiers

PMID37902939
PMCPMC10632290
OpenAlexW4388022957

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.