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Evidence-based triple antihypertensive therapy yields lower mortality in older patients with diabetes mellitus.

See related article, p 259–264

The use of initial single-pill combination antihypertensive therapy has been present since 1966 with the single-pill combination of reserpine, hydrochlorothiazide, and hydralazine widely available and used.1 Since the 1980s, there have been several antihypertensive combinations using drug classes with complementary pharmacological mechanisms joined in a single pill or given independently to help achieve blood pressure (BP) goals.2 The post hoc analysis of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial in the current issue of the journal extends our data on the use of antihypertensive combinations to help achieve BP goals.3

Initial single-pill combination therapy for treatment of hypertension has been strongly supported by guidelines in both the United States and Europe since 2003.2 The data are now overwhelming that the use of single-pill combination antihypertensive agents is associated with improved adherence, fewer adverse effects, and a higher attainment of BP goals.2,4 A randomized multicenter clinical trial to assess achievement of BP goals …