{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:00:16Z","timestamp":1776085216054,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Fixed\u2010dose combination (FDC) therapy is recommended for hypertension management in Nigeria based on randomized trials at the individual level. This cluster\u2010randomized trial evaluates effectiveness and safety of a treatment protocol that used two\u2010drug FDC therapy as the second and third steps for hypertension control compared with a protocol that used free pill combinations. From January 2021 to June 2021, 60 primary healthcare centers in the Federal Capital Territory of Nigeria were randomized to a protocol using FDC therapy as second and third steps compared with a protocol that used the same medications in free pill combination therapy for these steps. Eligible patients were adults (\u226518 years) with hypertension. The primary outcome was the odds of a patient being controlled at their last visit between baseline to 6\u2010month follow\u2010up in the FDC group compared to the free pill group. 4427 patients (mean [SD] age: 49.0 [12.4] years, 70.5% female) were registered with mean (SD) baseline systolic\/diastolic blood pressure 155 (20.6)\/96 (13.1) mm Hg. Baseline characteristics of groups were similar. After 6\u2010months, hypertension control rate improved in the two treatment protocols, but there were no differences between the groups after adjustment (FDC\u00a0=\u00a053.9% versus free pill combination\u00a0=\u00a047.9%, cluster\u2010adjusted <jats:italic>p<\/jats:italic>\u00a0=\u00a0.29). Adverse events were similarly low (&lt;1%) in both groups. Both protocols improved hypertension control rates at 6\u2010months in comparison to baseline, though no differences were observed between groups. Further work is needed to determine if upfront FDC therapy is more effective and efficient to improve hypertension control rates.<\/jats:p>","DOI":"10.1111\/jch.14632","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T08:40:13Z","timestamp":1674204013000},"page":"127-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fixed\u2010dose combination therapy\u2010based protocol compared with free pill combination protocol: Results of a cluster randomized trial"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-1098","authenticated-orcid":false,"given":"Olutobi A.","family":"Sanuade","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences Spencer Fox Eccles School of Medicine at the University of Utah  Salt Lake City Utah USA"},{"name":"Department of Medical Social Sciences and Robert J Havey Institute for Global 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