Initial hypertension evaluation

Key Findings

• SPC1001 High reduced mean sitting systolic blood pressure by 7.50 mmHg versus candesartan 8 mg and by 7.68 mmHg versus amlodipine 5 mg; its difference versus amlodipine 10 mg was 0.03 mmHg.
• SPC1001 Mid2 reduced mean sitting systolic blood pressure by 8.72 mmHg versus both candesartan 8 mg and amlodipine 5 mg, and by 18.02 mmHg versus placebo.
• The trial recorded 2 serious adverse events, documenting the safety signal alongside the blood-pressure reductions.

Key Findings

• Compared with morning dosing, bedtime dosing reduced nighttime systolic blood pressure by 4.87 mmHg and nighttime diastolic blood pressure by 2.80 mmHg in the overall hypertensive population.
• In trials restricted to non-dippers, bedtime dosing reduced nighttime systolic blood pressure by 7.57 mmHg and diastolic blood pressure by 3.77 mmHg.
• Populations with at least 60% non-dippers had approximately 9.7 mmHg greater nighttime systolic blood-pressure reduction versus about 4.4 mmHg in populations with lower non-dipper prevalence.

Key Findings

• Over a median 5.0-year follow-up, 668 of 4,989 participants without baseline hypertension developed hypertension; pitavastatin was associated with a 17% relative reduction in incidence versus placebo.
• Older age, higher body-mass index, metabolic syndrome, reduced estimated glomerular filtration rate, and Black race in high-income regions were associated with incident hypertension.
• Incident hypertension was associated with more than twice the subsequent risk of major adverse cardiovascular events (subdistribution hazard ratio 2.16, 95% CI 1.32-3.52).

Key Findings

• Across 11 studies involving 39,286 high-risk patients, high adherence was more common with polypill therapy than with standard monocomponent treatment (risk ratio 1.434, 95% CI 1.26-1.64; p<0.001).
• Polypill therapy was associated with increased high adherence in populations including patients with arterial hypertension, prior myocardial infarction, dyslipidemia, and high cardiovascular risk.
• The review identified follow-up duration, number of visits, baseline adherence, and patient education as factors that may improve adherence outcomes alongside the polypill.

Key Findings

• At 12 months postpartum, primary-care attendance was higher with health coaching and self-measured blood pressure than with usual care (71.0% vs 39.1%; relative risk 2.00, 95% CI 1.34-2.97; p<0.001).
• The intervention produced greater reductions in systolic blood pressure by 5.6 mmHg and diastolic blood pressure by 4.5 mmHg from baseline to 12 months.
• Blood-pressure control below 130/80 mmHg was more likely in the intervention group than in the control group (55.3% vs 31.1%; relative risk 1.73, 95% CI 1.13-2.66; p=0.02).