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Fixed dose combinations of ACE inhibitors
B Rangoonwala1, W Schulz, B Bauer
1Medical Department, Hoechst AG, Hoechst Marion Roussel, Frankfurt am Main, Germany.
The British Journal of Clinical Practice
|December 1, 1996
Summary
Combining angiotensin-converting enzyme (ACE) inhibitors with other antihypertensives significantly improves blood pressure control in many patients. This combination therapy offers higher normalisation rates, approaching 80%, with good tolerability.
Area of Science:
- Cardiology
- Pharmacology
Background:
- First-line antihypertensive monotherapy normalizes blood pressure in only about 50% of patients.
- Many patients require combination therapy for effective blood pressure control.
Purpose of the Study:
- To review the clinical efficacy and tolerability of combination therapies involving angiotensin-converting enzyme (ACE) inhibitors.
- To assess the role of ACE inhibitor combinations in achieving target blood pressure goals.
Main Methods:
- Literature review of clinical trials evaluating ACE inhibitor combination therapies.
- Analysis of efficacy and tolerability data for combinations with diuretics and calcium antagonists.
- Consideration of limited data on ACE inhibitors with beta-blockers.
Main Results:
- Combinations of ACE inhibitors with diuretics or calcium antagonists demonstrate significant efficacy.
- Near 80% blood pressure normalisation rates are achievable with submaximal doses in combination therapy.
- ACE inhibitor combinations are generally well-tolerated, mitigating some side effects of monotherapy.
Conclusions:
- Combination therapy, particularly with ACE inhibitors, is effective for patients not adequately controlled by monotherapy.
- Individualized selection of drug combinations, considering patient factors, is crucial for optimal outcomes.
- Further data are needed on ACE inhibitor and beta-blocker combinations.