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Fixed-dose combination therapy in hypertension: pros.
MedLine Citation:
PMID:  22867090     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Effective treatment of high blood pressure represents a key strategy for reducing the burden of hypertension-related cardiovascular diseases, mostly myocardial infarction and stroke. Despite these well established concepts, however, hypertension remains poorly controlled, worldwide. In addition, treated hypertensive patients often remain at higher risk compared with the normotensive population, even when a satisfactory blood pressure control is achieved, due to the high or very high added cardiovascular risk profile observed in these patients. An emerging strategy to improve blood pressure control and achieve this unmet target for cardiovascular disease prevention in hypertensive patients is represented by a more extensive use of rational and effective combination therapies with respect to monotherapy. Such an approach has been recently proposed even as first-line strategy in hypertensive patients at high added cardiovascular risk or in those in whom strict blood pressure control is required. Within the possible antihypertensive drug combinations currently available for the clinical management of hypertension, those based on the association of drugs inhibiting the renin-angiotensin system and thiazide diuretics or calcium channel blockers have demonstrated to be effective and safe in lowering both systolic and diastolic blood pressure levels with a good tolerability profile. In addition, these strategies have provided evidence for effective cardiovascular protection compared with conventional antihypertensive therapies. Among the antihypertensive drugs able to counteract the deleterious effects of abnormal activation of the renin-angiotensin system, angiotensin II receptor blockers have demonstrated to provide better tolerability profile and greater cardiovascular protection on hypertension-related organ damage compared with ACE inhibitors in randomized controlled clinical trials, in the presence of similar antihypertensive efficacy and safety. In particular, these drugs are characterized by lower rates of drug-related side effects, better compliance and adherence to prescribed antihypertensive regimens, and use in synergistic and rational combination therapies, all factors that may contribute to improve blood pressure control and reduce discontinuations from antihypertensive therapy in treated hypertensive patients. Received for publication 9 May 2012; accepted for publication 4 July 2012.
Authors:
Stefano Taddei
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension     Volume:  19     ISSN:  1179-1985     ISO Abbreviation:  High Blood Press Cardiovasc Prev     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-08-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421087     Medline TA:  High Blood Press Cardiovasc Prev     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  55-7     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Pisa, Pisa, Italy.
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