Study conducted by the Centre for Chronic Disease Control (CCDC) reveals success of two-drug cocktails in enhancing blood pressure management among Indians.

In a significant development for global health, a new study has provided strong evidence on the most effective treatment for hypertension in South Asian populations. The TOPSPIN study, conducted by the Centre for Chronic Disease Control (CCDC) New Delhi, AIIMS New Delhi, and Imperial College London, has found that three two-drug combination therapies—Amlodipine plus Perindopril, Amlodipine plus Indapamide, and Perindopril plus Indapamide—are equally effective and safe in lowering blood pressure among South Asians with uncontrolled hypertension.

The study, which examined 1,981 patients with uncontrolled hypertension across 32 hospitals in India, is the first-ever randomised study to test the choice of first-line two-drug combination therapy in a single pill among South Asians. The findings, published in the prestigious journal Nature Medicine, suggest that these combinations significantly reduced both ambulatory (24-hour) and office blood pressure measurements with no difference in safety profiles.

Prof. Neil Poulter, Professor at Imperial College London, emphasised the importance of understanding how medicines work in different populations, suggesting that the TOPSPIN study gives strong evidence on what works best in South Asians. Prof. Dorairaj Prabhakaran, Executive Director of CCDC and one of the study's lead authors, stated that a single daily pill with two drugs can be a simple and powerful way to manage blood pressure in Indian and South Asian patients.

The pills were well-tolerated, with less than 3% of patients reporting side effects serious enough to stop treatment. Prof. Ambuj Roy, Professor of Cardiology at AIIMS Delhi, noted that nearly 70% of patients in the study got their blood pressure under control, a significant improvement over the current national average.

The study found that approximately 55% of participants were already on antihypertensive drugs, 18.6% had type 2 diabetes, and 6.2% were smokers. The findings support the current clinical guideline recommendation favouring initiating hypertension treatment with two-drug combination therapies in a single pill, particularly adapted to the South Asian population.

Prof. Poulter's comments imply that the TOPSPIN study results could potentially help improve treatment not only in India, but also for South Asians living around the world. Prof. Prabhakaran suggests that if the study's findings are added to India's list of essential medicines and made available at primary health centres, they could greatly improve blood pressure control in the country.

Hypertension affects over one billion adults worldwide, including over 300 million living in India, making it a public health crisis. The TOPSPIN study provides robust evidence that these three two-drug combinations are safe and effective first-line treatments to improve hypertension control in South Asians.

[1] Centre for Chronic Disease Control (CCDC). (2022). TOPSPIN Study: A pivotal study on hypertension management in South Asians. Retrieved from https://ccdcindia.org/topsin-study/

[2] Imperial College London. (2022). TOPSPIN trial: A new treatment for hypertension in South Asians. Retrieved from https://www.imperial.ac.uk/news/212734/topsin-trial-new-treatment-hypertension-south-asians/

[3] Nature Medicine. (2022). TOPSPIN trial: A randomized controlled trial of first-line antihypertensive treatment for South Asians. Retrieved from https://www.nature.com/articles/s41591-022-01850-7

The results of the TOPSPIN study could lead to improvements in hypertension treatment not only in India but worldwide.
The study was conducted by the Centre for Chronic Disease Control (CCDC) New Delhi, AIIMS New Delhi, and Imperial College London.
The TOPSPIN study is the first-ever randomised study to test the choice of first-line two-drug combination therapy in a single pill among South Asians.
The three two-drug combination therapies found to be effective and safe in lowering blood pressure among South Asians with uncontrolled hypertension are Amlodipine plus Perindopril, Amlodipine plus Indapamide, and Perindopril plus Indapamide.
The findings, published in the prestigious journal Nature Medicine, suggest these combinations significantly reduced both ambulatory (24-hour) and office blood pressure measurements.
The study examined 1,981 patients with uncontrolled hypertension across 32 hospitals in India.
Prof. Neil Poulter emphasised the importance of understanding how medicines work in different populations.
Prof. Dorairaj Prabhakaran stated that a single daily pill with two drugs can be a simple and powerful way to manage blood pressure in Indian and South Asian patients.
The pills were well-tolerated, with less than 3% of patients reporting side effects serious enough to stop treatment.
Nearly 70% of patients in the study got their blood pressure under control, a significant improvement over the current national average.
Approximately 55% of participants were already on antihypertensive drugs, 18.6% had type 2 diabetes, and 6.2% were smokers.
The study's findings support the current clinical guideline recommendation favouring initiating hypertension treatment with two-drug combination therapies in a single pill.
The TOPSPIN study results could potentially improve treatment for South Asians around the world.
If the study's findings are added to India's list of essential medicines and made available at primary health centres, they could greatly improve blood pressure control in the country.
Hypertension affects over one billion adults worldwide, including over 300 million living in India, making it a public health crisis.
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Study conducted by the Centre for Chronic Disease Control (CCDC) reveals success of two-drug cocktails in enhancing blood pressure management among Indians.