A groundbreaking study, led by AIIMS Delhi and supported by WHO and ICMR, has revealed that two-drug combinations for managing hypertension are five times more effective than single-drug therapies in achieving blood pressure (BP) control. The multi-center trial, named TOPSPIN, enrolled nearly 2,000 Indian patients and tested three combinations:
Amlodipine & Perindopril
Amlodipine & Indapamide
Perindopril & Indapamide
Key Findings
- Over 70% of participants achieved BP control under 140/90 mm Hg in just 6 months.
- The combinations lowered BP significantly—up to 30/14 mm Hg in clinical settings.
- The therapy also achieved stricter targets of 130/80 mm Hg in 40% of patients.
- Adverse effects were minimal, with fewer than 3% discontinuing treatment.
Filling a Critical Gap in Indian Hypertension Care
With hypertension affecting nearly 30% of Indians but with low treatment success rates, just 11% in rural areas and 20% in urban, this trial offers evidence-backed therapies tailored for South Asian populations. Current treatment guidelines in India often rely on international data, which may not fully address the unique needs of Indian patients.
Implications for Clinical Practice
The results underscore the importance of combination therapy as a first-line treatment for rapid and sustained BP control, replacing traditional monotherapy in most cases. Also, physicians can confidently prescribe any of the tested combinations, ensuring effectiveness and safety.
“This research fills a critical knowledge gap in hypertension management for South Asians,” said Dr. Ambuj Roy from AIIMS, emphasizing its potential to transform how cardiologists manage high BP.
The findings promise to influence national and global hypertension treatment guidelines, equipping healthcare providers with the tools to significantly improve BP control rates. Doctors are encouraged to explore these combinations as a single-pill therapy option to better combat India’s growing hypertension burden.
