The TOPSPIN trial, led by AIIMS Delhi, found that three commonly used two-drug combination pills for hypertension showed equal effectiveness in reducing blood pressure among South Asian patients, with all combinations achieving approximately 14/8 mmHg reduction in 24-hour ambulatory measurements.
Nearly 70% of the 1,981 participants achieved blood pressure control below 140/90 mmHg after 6 months of treatment, representing a significant improvement over current national control rates in India.
All three combinations (amlodipine-perindopril, amlodipine-indapamide, and perindopril-indapamide) demonstrated similar safety profiles with less than 3% of participants discontinuing therapy due to side effects.
The study provides the first robust evidence for optimal dual combination therapy in South Asian populations, who represent a quarter of the world's population and face an enormous hypertension burden with poor control rates.