[Drug combinations in the treatment of primary arterial hypertension]

A number of pathogenetic moments have been identified in primary or essential hypertension in recent years. Marked variations have been noted in plasma volume, cardiac output, neurosympathetic tone, the renin-angiotensin system, and the aldosterone-adrenal neurosympathetic regulation system. Biological and clinical studies have underscored the action of the individual hypotensive drugs at present available commercially and their synergic or, in some instances, antagonist effects when associated. The fact that the disease has different stages and that different points of attack can be chosen is an ecouragement to the combination and simultaneous employment of two or more hypotensive drugs. Known associations, such as reserpine (with or without sympathicoplegics) or vasodilators and the diuretics, are examined, together with more recent combinations, such as propranolol, hydralgine and the diuretics, and spirolactone and the diuretics.