Present and future role of combination treatment in hypertension

Both in clinical practice and in drug trials, combination treatment of hypertension plays a fundamental role. This article reviews the features that make combined therapy with two drugs valuable, i.e., additive antihypertensive efficacy, different mechanisms of action, and reciprocal side-effect minimization. Also examined are the advantages and disadvantages of a fixed combination, emphasizing that a major advantage is simplification of the treatment schedule. This is clinically relevant because complexity of treatment negatively affects patient compliance, which in hypertensive patients is poor, leading to poor long-term blood pressure control in the hypertensive fraction of the population.