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Strategies for combination therapy in hypertension
1Temple University School of Medicine (Clinical Campus), Pittsburgh, Pennsylvania 15232, USA. gradmana@temple.edu
Current Opinion in Nephrology and Hypertension
|August 9, 2012
Summary
Effective hypertension management often requires multiple medications. This review highlights rational drug combinations and efficient strategies for better blood pressure control and reduced cardiovascular events in patients.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Clinical Hypertension Management
Background:
- Most patients require multiple antihypertensive agents to reach target blood pressure (BP) goals.
- Hypertension affects over 46 million ambulatory care visits annually in the U.S.
- Current guidelines necessitate combination therapy for effective BP management.
Purpose of the Study:
- To review rational selection of effective antihypertensive drug combinations.
- To discuss efficient strategies for using combination therapy to achieve therapeutic objectives.
- To address the evolving landscape of hypertension treatment.
Main Methods:
- Literature review focusing on evidence-based antihypertensive combination therapies.
- Analysis of pharmacological principles for additive BP reduction.
- Evaluation of clinical trial data on drug combinations and patient outcomes.
Main Results:
- Recommended combinations offer complementary pharmacology and additive BP reduction.
- Chlorthalidone is increasingly favored over hydrochlorothiazide.
- Mineralocorticoid antagonists are key for resistant hypertension.
- Strategies evolve towards low-dose combinations and earlier initiation.
Conclusions:
- Judicious use of drug combinations is crucial for achieving BP targets and reducing cardiovascular endpoints.
- Evolving strategies include low-dose combinations and early initiation, especially for Stage 2 hypertension.
- Optimizing combination therapy improves patient outcomes in hypertension management.
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