A new scientific statement from the American Heart Association, published in the journal Hypertension, suggests that single-pill combination medications for high blood pressure may simplify treatment and improve long-term health outcomes. The statement, titled "Single-Pill Combination Therapy for the Management of Hypertension," reviews clinical evidence showing that combining two or more blood pressure medications into one pill can help patients reach target blood pressure levels more quickly and maintain them compared to taking multiple separate pills.
According to the 2025 American Heart Association Statistical Update, nearly half of U.S. adults—about 122 million people—have high blood pressure, defined as 130/80 mm Hg or higher. High blood pressure is the leading modifiable risk factor for cardiovascular disease and contributes to heart attack, stroke, heart failure, kidney disease, and dementia. The 2025 AHA/ACC High Blood Pressure Guideline recommends starting treatment with two medications, preferably in a single combination pill, for those with stage 2 hypertension (140/90 mm Hg or higher).
"Most people with high blood pressure need two or more medications to reach target levels, but taking multiple pills daily can be confusing or hard to keep up with," said Jordan B. King, Pharm.D., M.S., chair of the writing group. "Single-pill combinations are valuable tools. Individuals taking a single combination pill are able to achieve optimal blood pressure levels sooner than peers taking the same medications separately."
Benefits highlighted in the statement include simplified and faster treatment, streamlined prescribing for clinicians, and improved long-term heart health. Observational studies with follow-up periods of 1-5 years have linked single-pill combination use with a 15%-30% lower risk of major adverse cardiovascular events, such as heart attack, stroke, heart failure-related hospitalizations, and death. Additionally, combination pills are more cost-effective than separate pills, potentially reducing healthcare costs.
However, the statement identifies several barriers to widespread adoption. Prescriber awareness of available combination therapies is limited, and some clinicians have concerns about reduced flexibility in dosage adjustments. Affordability and accessibility are also issues, as many insurers, including Medicare and Medicaid, often require equivalent combinations prescribed as separate pills despite evidence of cost-effectiveness. The statement calls for streamlining insurance coverage and lowering copayments for single-pill medications.
More research is needed for high-risk populations, such as those with resistant or secondary hypertension, chronic kidney disease, diabetes, heart failure, or older adults. Currently, there are about 200 unique combinations of blood pressure medications used in the U.S., and expanding options for triple and quadruple combinations could further simplify treatment, according to the statement.
"If single-pill combinations were the norm rather than the exception, there could be a meaningful improvement in blood pressure control across the population, which could significantly reduce the risk of heart attacks and strokes," King said. The statement was prepared by the American Heart Association's Council on Hypertension; the Council on Cardiovascular and Stroke Nursing; and the Council on Clinical Cardiology.
For more information, the full statement is available online at this link. Additional resources include the American Heart Association's health information on High Blood Pressure and the High Blood Pressure Resources page.
