Adverse Effects and Treatment Discontinuation of Blood Pressure–Lowering Drugs and Combinations

Do antihypertensive drug classes and combinations result in different levels of adverse drug effects and drug withdrawal in short-term, double-blind randomized clinical trials?In this network meta-analysis that included 716 trials and 159 362 participants, the best-tolerated treatment was a 2-drug combination of an angiotensin II receptor blocker plus calcium channel blocker, and 4 of the top 5 best-tolerated regimens contained angiotensin II receptor blockers. Some combination therapies were better tolerated than monotherapy and/or placebo.In short-term randomized clinical trials, adverse drug effects that led to discontinuation of blood pressure–lowering therapy varied by drug class and regimen, with several combination therapies being better tolerated than monotherapies and placebo.

Corresponding Author: Anthony Rodgers, PhD, The George Institute for Global Health, Level 8, 55 Botany St, Randwick, NSW 2031, Australia (arodgers@georgeinstitute.org).

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