Principles of antihypertensive drug treatment

The main objectives of chronic drug treatment in essential hypertension are to decrease blood pressure, improve prognosis, reduce the number and severity of adverse effects to a minimum, and use simple treatment schedules. Simple treatment schedules may be easily maintained with monotherapy (i.e., beta blockers, diuretics, calcium antagonists and angiotensin-converting enzyme inhibitors). If monotherapy is insufficiently effective, antihypertensive drugs can be combined. Combination therapy makes use of the synergistic effects of most antihypertensive drugs. Further considerations of combination therapy of antihypertensive agents are the inhibition of compensatory mechanisms working against blood pressure reduction and the decrease of the frequency and severity of adverse effects. Combinations of 2 antihypertensive agents usually contain a diuretic or a calcium antagonist.