Single Pill Combinations as Initial Therapy in the Management of Hypertension: What is Taking you so Long?

In 2017, 2 respected hypertension guidelines, those of Hypertension Canada and those of the Latin American Society of Hypertension added another treatment to their listing of first line (initial) pharmacological therapy for hypertension.^1,2 This event, unlikely to be reported by CNN or Fox was still newsworthy for 2 reasons. First, it is the only new therapy added to that list in almost 2 decades (at least in Canada). Second, the therapy was one that had been used in hypertension for more than 50 years. The treatment? Single pill combinations (SPCs) of 2 antihypertensive drugs. The examination of the duration of time it took from the initial introduction of SPCs in therapy to their recognition as first line in an increasing number of countries (but not in the United States) is illustrative of the limitations of our current approach in the identification and implementation of best practices.

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