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Combination therapy in hypertension

Alan H Gradman1, Jan N Basile, Barry L Carter

  • 1The Western Pennsylvania Hospital, Pittsburgh, Pennsylvania and Temple University School of Medicine, Philadelphia, PA 15224, USA. grandmamd@aol.com

Journal of the American Society of Hypertension : JASH
|April 9, 2010
PubMed

Insights

Achieving blood pressure (BP) targets often requires combination therapy for hypertension. This paper reviews the rationale, drug choices, and patient selection for effective BP management.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Antihypertensive therapy aims to reduce cardiovascular risks without compromising quality of life.
  • Blood pressure (BP) reduction is the primary factor in mitigating cardiovascular (CV) events.

Purpose of the Study:

  • To present a Position Paper on Combination Therapy for Hypertension from the American Society of Hypertension.
  • To address the scientific basis and pharmacologic rationale for antihypertensive drug combinations.
  • To review patient selection and implications of recent clinical trials on combination strategies.

Main Methods:

  • Review of available data on BP reduction and CV risk.
  • Analysis of pharmacologic principles for combining antihypertensive drugs.
  • Discussion of clinical trial data regarding specific combination strategies.

Main Results:

  • At least 75% of patients require combination therapy to reach BP goals.
  • BP reduction itself is the main driver of CV risk reduction.
  • Fixed-dose combination pills offer practical advantages and disadvantages.

Conclusions:

  • Combination therapy is essential for achieving BP targets in most hypertensive patients.
  • Strategic drug selection and patient assessment are crucial for effective hypertension management.
  • Understanding combination therapy benefits and drawbacks optimizes patient outcomes.

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