About 10 million Brits take multiple drugs for the killer condition, which is the single biggest trigger of heart disease and stroke.
But experts warn only half are managing their illness effectively.
High-risk patients are initially prescribed a single pill, before getting a second drug to lower their blood pressure.
But leading researchers warn GPs are often failing to dole out the extra medication.
And patients taking several drugs are four times more likely to miss a dose compared to those taking just one tablet – put off by the extra cost and hassle.
New guidelines from the European Society of Cardiology say starting millions of Brits with high blood pressure on a single treatment containing two drugs would slash stroke and heart deaths.
Professor Bryan Williams, from University College London, who helped write the guidance said combination pills cost just 5p a day.
But despite the benefits, few patients in the UK get them.
Speaking at the ESC Congress in Munich [must keep], he said: “The vast majority of patients with high blood pressure should start treatment with two drugs as a single pill.
“These pills are already available.
Wider use resulted in better compliance with treatment and therefore better blood pressure control, this could lead the prevention of thousands more strokes and heart attacks per year.”
NHS watchdog the National Institute for Health and Care Excellence is now looking at whether patients should get combination pills as part of a 2019 review.
Professor Williams added: “We have been using the same approach to lower blood pressure for the last 40 years and the improvements have been too slow and too many people are dying as a consequence.
“We have to do something more drastic. Using more combinations pills would definitely save lives.”
High blood pressure is known as the silent killer, because the symptoms often go unnoticed until it is too late.
Under NHS rules, it is a reading over 140/90mmHg – meaning one in three adults are eligible for treatment.
Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said: “Around 40 per cent of people with high blood pressure are undiagnosed and many of those who are diagnosed aren’t managing their condition properly, even though we already have several effective medicines.
“The majority of people with high blood pressure have no symptoms, so part of the problem is that none of us like taking pills when we don’t feel their benefit – and treatment becomes even more challenging when more than one pill is needed to control your blood pressure.
“The new guidelines suggest starting most patients with high blood pressure on a combination of two medicines in one pill.
If adopted widely, this recommendation has the potential to improve effective blood pressure control and thus to reduce the risk of heart attacks and stroke.”
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