PERHAPS combination therapy is just what the doctor ordered for high blood pressure sufferers.

The chronic disease, which is poorly controlled throughout the world, may be better managed with new drugs that pack a double whammy.

An international expert in hypertension from Switzerland explained that studies showed patients who take an additional diuretic medicine with their traditional regular hypertension drug had blood pressure levels that were effectively controlled all day long.

And instead of taking two or more separate pills, there are now pills on the market which combine the drugs, such as Olmatec Plus, which was introduced last month.

In comparison, the effect of daily pills, while highest in the few hours after being ingested, wears off and has little effect on blood pressure within 24 hours.

Professor Emeritus Hans Brunner, who was in town late last month to speak to about 100 doctors at a forum, said a combination pill might fix the problem of poor high blood pressure control.

"It's a very common problem," he said, citing how just 10 per cent of European patients have "normalised blood pressures".

In Singapore, studies have shown that only 40 per cent of patients have their hypertension under control. What this means is many people are still at high risk of having heart attacks, strokes and kidney problems.

A decrease of 2mmHg - the unit by which blood pressure is measured - can reduce risk of stroke by 6 per cent and risk of heart disease by 4 per cent.

For one thing, these newer drugs may have properties that better protect the organs, said cardiologist Baldev Singh, who has practised for about 35 years.

Combination drugs may also provide "counter-balances to the side effects of each of their individual components", Dr Titus Lau from National University Hospital added.

The specialist in hypertension and kidney disease said combination drugs can also "act on more than one pathway", such as controlling hormones and aiding salt excretion to reduce blood pressure - all at the same time.

But for patients, the most obvious difference is that two-in-one pills will mean patients take fewer pills, thus "improving compliance", doctors said.

A 50-year-old teacher, who wanted to be known only as Ms Chan, said that combination pills definitely sugarcoated the situation of having to take more medication.

"Of course it's easier to take just one pill," Ms Chan said.

"It's more convenient, you won't forget which ones you've already taken, and you won't have to carry around so many pills."

Besides, this could "overcome the prejudice that more pills are harmful", Dr Lau said.

"Patients are always happier to take just one pill."

serl@sph.com.sg