24-month single-pill, triple antihypertensive therapy in rural Rwanda

INTRODUCTION: Arterial hypertension is a leading modifiable cardiovascular risk factor. Recent guidelines recommend single-pill, low-dose combinations as initial pharmacological strategy. We investigated the long-term feasibility and sustained effect of such a strategy in a remote rural area of Southern Rwanda, in sub-Saharan Africa. METHODS: Hypertension was diagnosed using three sets of blood pressure measurements obtained according to European Society of Hypertension recommendations using a validated oscillometric device (OMRON M7 IT-HEM-7322-E). Individuals meeting diagnostic criteria were initiated on a single-pill combination of amlodipine, hydrochlorothiazide, and olmesartan. Treatment dosage was reassessed and adjusted as needed at each outpatient clinic visit. RESULTS: Fifty-seven Black African participants with confirmed uncomplicated, untreated hypertension (aged 65 [54-70] years; median and interquartile range) had follow-up data available for up to 24 months after inclusion. Blood pressure