What do systematic reviews say?

Combination therapy vs monotherapy

It is very uncertain whether combination therapy changes withdrawals due to adverse effects compared with monotherapy (very low certainty).

• First‐line combination therapy versus first‐line monotherapy for primary hypertension 2020 · Cochrane Headline outcomes only
  RR 0.85 [0.53, 1.35]
  3 studies · 568 participants
  Very low

Combination with potassium‐sparing diuretics vs monotherapy

• First‐line combination therapy versus first‐line monotherapy for primary hypertension 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 200 participants
  Very low

Intervention not reported

The intervention probably leads to higher withdrawals due to adverse effects 5 years (moderate certainty).

• Pharmacotherapy for mild hypertension 2012 · Cochrane Headline outcomes only
  RR 4.8 [4.14, 5.57]
  1 study · 17354 participants
  Moderate

Uric acid lowering therapies (UAR) vs placebo

Uric acid‐lowering drug showed no clear difference in adverse events (withdrawals due to side effects) compared with placebo (low certainty).

• Pharmacotherapy for hyperuricaemia in hypertensive patients 2020 · Cochrane Headline outcomes only
  RR 1.86 [0.43, 8.1]
  3 studies · 241 participants
  Low

Any antihypertensive drug vs placebo or no treatment

Antihypertensive drug may leads to higher withdrawals due to adverse effects Mean duration of 4.6 years compared with placebo or no treatment (low certainty).

• Pharmacotherapy for hypertension in adults 60 years or older 2019 · Cochrane Headline outcomes only
  RR 2.91 [2.56, 3.3]
  4 studies · 11310 participants
  Low