Evidence map›Paper›PMID 40488970›Full record

SynthesisHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2025

Efficacy and Safety of Low-Dose Triple Single Pill Combination Versus Standard Care in the Management of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis of Three Randomized Controlled Trials.

Umar G Adamu, Kabo Mojela, El-Ameen U Adamu, Dike Ojji, Nqoba Tsabedze

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. 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
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

5 authors.

Umar G AdamuDivision of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, South Africa. umar.adamu@wits.ac.za.ORCID http://orcid.org/0000-0002-5942-2668
Kabo MojelaDivision of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, South Africa.ORCID http://orcid.org/0009-0005-7199-9995
El-Ameen U AdamuCollege of Health Sciences, Usmanu DanFodiyo University, Sokoto, Nigeria.
Dike OjjiDepartment of Internal Medicine, University of Abuja, Abuja, Nigeria.ORCID http://orcid.org/0000-0002-2084-1988
Nqoba TsabedzeDivision of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, South Africa.ORCID http://orcid.org/0000-0002-7210-1447

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLow Low-dose triple single pill combination therapy is recommended for hypertension treatment. However, the efficacy and safety of these combinations in low- and middle-income countries (LMICs) remain unclear.

aimWe conducted a systematic review and meta-analysis to evaluate the efficacy and safety of low-dose triple single pill combination therapy in controlling blood pressure (BP) in LMICs.

methodsWe systematically searched PubMed, Embase, Cochrane, and ClinicalTrials.gov for randomised controlled trials (RCTs) comparing low-dose triple single pill combination therapy with standard care for hypertension management up to 29 January 2025. Mean differences (MD) were computed for continuous outcomes and risk ratio (RR) with 95% confidence intervals (CI) for binary outcomes.

resultsThree RCTs comprising 1758 patients, of whom 752 (43%) received low-dose triple single pill combination therapy, were included. The proportion of patients that achieved target BP at six weeks was higher with this therapy (RR 1.89; 95% CI 1.29, 2.75; P < 0.001). Compared with standard care, it significantly reduced SBP (MD - 5.30 mmHg; 95% CI - 9.55, - 0.92; P = 0.017), DBP (MD - 3.50 mmHg; 95% CI - 4.95, - 2.05; P < 0.001), and urine albumin-to-creatinine ratio (RR 0.59; 95% CI 0.44, 0.80; P < 0.001). No significant differences in adherence, withdrawal, or adverse effects were observed between groups.

conclusionIn this meta-analysis, the use of a low-dose triple single pill combination in hypertensive patients in LMICs led to earlier and sustained blood pressure control and reduced urine albumin-to-creatinine ratio, with a safety profile comparable to standard care. PROSPERO registration: Number: CRD42025647884, Date: 15 February 2025.

Indexed as

Antihypertensive AgentsBlood PressureDeveloping CountriesHypertensionDrug CombinationsHumansRandomized Controlled Trials as TopicTime FactorsTreatment OutcomeAntihypertensive AgentsDrug CombinationsBlood pressure controlHypertensionLow- and middle-income countries (LMICs)Low-dose triple single pill combination therapyMeta-analysisRandomized controlled trials (RCTs)

Identifiers

PMID40488970
PMCPMC12310858

What OpenQuestion 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 OpenQuestion graph.