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Creating a combination antihypertensive regimen: what does the research show?
1State University of New York, Downstate College of Medicine, Brooklyn, NY, USA. michaelwebermd@cs.com
Journal of Clinical Hypertension (Greenwich, Conn.)
|August 28, 2003
Summary
Most patients with hypertension need multiple medications. Combination therapy may offer greater heart protection than single-drug treatments, but optimal regimens require further study.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Management
Background:
- Major trials show blood pressure lowering benefits but no single drug superiority.
- Most hypertension patients require multiple medications for control.
- Guidelines increasingly recommend initial combination therapy.
Purpose of the Study:
- To determine optimal antihypertensive combination regimens for maximal cardiovascular benefits.
- To compare cardiovascular mortality and morbidity rates of two fixed-dose combination therapies.
Main Methods:
- The ACCOMPLISH trial directly compares two preselected, fixed-dose combination therapies.
- Focus on cardiovascular mortality and morbidity rates.
Main Results:
- Combination therapy may provide greater cardioprotection than monotherapy.
- Low-dose ACE inhibitor and calcium channel blocker combination improved cardiovascular structure and function compared to monotherapy (ALERT trial).
Conclusions:
- Optimal combination therapy regimens for hypertension are not yet established.
- Further research is needed to identify the most beneficial combination strategies for patients.
- The ACCOMPLISH trial aims to provide critical data on combination therapy efficacy.