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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Reduced efficacy of blood pressure lowering drugs in the presence of diabetes mellitus—results from the TRIUMPH randomised controlled trial
Hypertension Research, Volume 46, No. 1, Year 2023
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Description
We investigated whether diabetes mellitus (DM) affects the efficacy of a low-dose triple combination pill and usual care among people with mild-moderate hypertension. TRIUMPH (TRIple pill vs Usual care Management for Patients with mild-to-moderate Hypertension) was a randomised controlled open-label trial of patients requiring initiation or escalation of antihypertensive therapy. Patients were randomised to a once-daily low-dose triple combination polypill (telmisartan-20mg/amlodipine-2.5 mg/chlorthalidone-12.5 mg) or usual care. This analysis compared BP reduction in people with and without DM, both in the intervention and control groups over 24-week follow-up. Predicted efficacy of prescribed therapy was calculated (estimation methods of Law et al.). The trial randomised 700 patients (56 ± 11 yrs, 31% DM). There was no difference in the number of drugs prescribed or predicted efficacy of therapy between people with DM and without DM. However, the observed BP reduction from baseline to week 24 was lower in those with DM compared to non-diabetics in both the triple pill (25/11 vs 31/15 mmHg, p ≤ 0.01) and usual care (17/7 vs 22/11 mmHg, p ≤ 0.01) groups, and these differences remained after multivariable adjustment. DM was a negative predictor of change in BP (β-coefficient −0.08, p = 0.02). In conclusion, patients with DM experienced reduced efficacy of BP lowering therapies as compared to patients without DM, irrespective of the type of BP lowering therapy received. © 2022, The Author(s), under exclusive licence to The Japanese Society of Hypertension.
Authors & Co-Authors
Gnanenthiran, Sonali Rukshana
Australia, Sydney
George Institute for Global Health
Webster, Ruth J.
Australia, Sydney
George Institute for Global Health
Australia, Sydney
Unsw Sydney
Silva, Asita De
Sri Lanka, Kelaniya
University of Kelaniya
Maulik, Pallab K.
Australia, Sydney
George Institute for Global Health
Salam, Abdul
Australia, Sydney
George Institute for Global Health
Selak, Vanessa
New Zealand, Auckland
The University of Auckland
Guggilla, Rama K.
Poland, Bialystok
Uniwersytet Medyczny w Bialymstoku
Schutte, Aletta E.
Australia, Sydney
George Institute for Global Health
Patel, Anushka A.
Australia, Sydney
George Institute for Global Health
Rodgers, Anthony J.
Australia, Sydney
George Institute for Global Health
Weerawardena, Shalomi
Unknown Affiliation
Tazeen, Ayesha
Unknown Affiliation
Statistics
Citations: 2
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1038/s41440-022-01051-7
ISSN:
09169636
Research Areas
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cohort Study