Triple therapy with angiotensin receptor blockers (ARBs)/amlodipine + rosuvastatin significantly reduces blood pressure (BP) and cholesterol levels in patients with hypertension and dyslipidaemia compared with dual therapies involving ARBs/amlodipine or ARBs + rosuvastatin, according to a recent study.
A significant percentage of patients diagnosed with hypertension concurrently have dyslipidaemia. [Korean Circ J 2016;46:672-680] Previous research demonstrated a direct correlation between blood cholesterol levels and cardiovascular disease (CVD), emphasizing the importance of lowering cholesterol levels to effectively mitigate CVD risk. [Eur Heart J 2016;37:2315-2381]
“As a result, recent hypertension management has focused not only on lowering BP but also on reducing overall CVD risk and this can be achieved by lifestyle modification and optimizing medication regimens to improve patient compliance and clinical outcomes,” the researchers said.
This systematic review and meta-analysis comprised seven randomized clinical trials comparing triple and dual therapy in patients diagnosed with both hypertension and dyslipidaemia. A total of 1,074 participants (67.6 percent male) who received triple (mean age 64.5 years) or dual therapy (mean age 63.75 [ARBs/amlodipine] and 63.25 years [ARBs + rosuvastatin]) over an 8-week period were included. [Egypt Heart J 2026;doi:10.1186/s43044-026-00720-z]
At baseline, the triple therapy group had a mean systolic BP (mSBP) of 152.15 mm Hg and a mean low-density lipoprotein cholesterol (LDL-C) of 154.97 mg/dL. Among those treated with ARBs/amlodipine, the msBP was 150.70 mm Hg and the mean LDL-C was 154.91 mg/dL. In the ARBs + rosuvastatin group, the corresponding values were 151.62 mm Hg and 156.85 mg/dL, respectively.
Triple therapy vs ARBs/amlodipine
Compared with ARBs/amlodipine, patients receiving triple therapy achieved significantly reduced levels of mSBP (mean difference [MD], –4.06; p=0.04) and mean diastolic BP ([mDBP]; MD, –5.45; p<0.0001).
Furthermore, a significant improvement in LDL-C and high-density lipoprotein cholesterol (HDL-C) levels was observed with triple therapy than with dual therapy (MD, –50.10; p<0.00001 and MD, 8.7; p<0.0001, respectively).
However, the triglyceride levels did not differ between the treatment groups (MD, –6.89; p=0.13).
Triple therapy vs ARBs + rosuvastatin
“Considering the close association between hypertension and dyslipidaemia—which are major risk factors for CVD —earlier investigations have explored the efficacy of integrating antihypertensive agents with lipid-lowering medications, such as statins,” said the researchers.
Compared with ARBs + rosuvastatin, patients who received triple therapy had a significant reduction in mSBP and mDBP levels (MD, –12.28; p<0.00001 and MD, –6.48; p=0.005, respectively).
All lipid profiles, including LDL-C (MD, –2.07; p=0.19), HDL-C (MD, –2.58; p=0.58), and triglycerides (MD, 1.91; p-0.58), showed no significant differences between groups.
The incidences of total adverse events were not significant different between the triple and dual therapy groups (risk ratios [RRs], 1.09; p=0.66 [ARBs/amlodipine] and RR, 1.06; p=0.79 [ARBs + rosuvastatin]), as were the incidences of adverse drug reactions (RRs, 1.03; p=0.93 and 1.41; p=0.27 respectively). These suggest that both treatment regimens were similarly safe, the researchers noted.
“Overall, our meta-analysis highlights that triple therapy with ARBs/amlodipine and rosuvastatin significantly lowers BP and improves lipid profiles compared with dual therapy in patients with hypertension and dyslipidaemia,” said the researchers.
“Future studies should focus on developing a single-pill triple-combination therapy and evaluating its impact on adherence and clinical outcomes,” they added.