Combining multiple antihypertensive medications into a single pill helped nearly 70% of patients achieve target blood pressure levels, an international clinical trial shows.
RT’s Three Key Takeaways:
- Higher Rates of Blood Pressure Control: Nearly 70% of patients receiving a single-pill combination therapy achieved target blood pressure levels, compared to just 29% of patients receiving typical care.
- Greater Reductions in Systolic Pressure: Patients assigned to the single-pill regimen experienced an average 19-point decrease in systolic blood pressure after 18 months, compared to a 9-point reduction among those receiving standard stepped care.
- Sustained Treatment Adherence: Six months after the trial ended, 75% of patients in the intervention group remained on single-pill combination therapy covered by health insurance or public programs, demonstrating the long-term feasibility of the strategy.
Combining multiple blood pressure medications into a single pill lowers blood pressure more effectively than conventional multi-pill treatments, according to a study co-led by researchers at UT Southwestern Medical Center.
The findings from the Caribbean and South American Team-Based Strategy to Control Hypertension (CATCH) randomized clinical trial were presented during the late-breaking science sessions at the 2026 American Heart Association (AHA) Scientific Sessions and published concurrently in JAMA.
“Our study demonstrated that a single-pill combination provided an effective, implementable, scalable, and sustainable approach for hypertension control in low- and middle-income countries,” said Jiang He, MD, chair of epidemiology in the Peter O’Donnell Jr School of Public Health and professor of internal medicine and neurology at UT Southwestern, in a news release. “It improves patients’ adherence to medication and satisfaction with medication and hypertension-related care. The trial also provides additional evidence for physicians to recommend this treatment to patients with high blood pressure in the US and beyond.”
Evaluating Long-Term Blood Pressure Management
Hypertension serves as the leading preventable risk factor worldwide for cardiovascular disease, chronic kidney disease, stroke, and dementia, as well as premature death from any cause, the researchers stated. Uncontrolled hypertension remains a persistent global challenge; only 22.5% of patients with hypertension in the US and 13.6% in low- and middle-income countries have their condition under control, according to the study authors.
While existing US and international clinical guidelines recommend single-pill combination therapy as the preferred frontline approach, previous clinical trials evaluated the regimen over only a few weeks, leaving questions about long-term efficacy and safety.
To assess long-term outcomes, researchers conducted the four-year CATCH trial, enrolling 1,706 patients with uncontrolled hypertension across 40 primary care clinics in Colombia and Jamaica.
Half of the clinics delivered standard “stepped care,” where patients begin on a single medication and clinicians incrementally add drugs or increase doses over time if blood pressure remains uncontrolled. In the intervention clinics, patients received a polypill combining two or three antihypertensive drugs, along with nurse training on home blood pressure monitoring and health coach support for treatment adherence.
Trial Findings and Clinical Adoption
After 18 months, patients taking the single-pill combination achieved an average systolic blood pressure reduction of about 19 points, compared to a 9-point decline in the usual care group, according to trial data. Furthermore, nearly 70% of the single-pill group achieved the target benchmark—defined as a systolic reading below 130 mm Hg and a diastolic reading below 80 mm Hg—compared to 29% of patients receiving stepped care.
Follow-up evaluations six months after the trial ended revealed that 75% of patients in the intervention group continued single-pill therapy under healthcare insurance or government programs while sustaining blood pressure control, according to the study.
Despite guideline recommendations, only approximately 10% of patients with high blood pressure in the US currently receive single-pill combination treatments, He noted in the news release. Physician surveys indicate this treatment gap stems from limited familiarity with combination formulations and a historical shortage of long-term trial evidence.
The study was supported by a grant from the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH), according to the researchers.
