Document Detail

Initial hypertension treatment: one combination fits most?
MedLine Citation:
PMID:  21414561     Owner:  NLM     Status:  In-Data-Review    
The absolute number of patients with uncontrolled hypertension is growing worldwide. Many factors may be involved, including physician inertia and patient nonadherence. In this context, we reviewed published studies related to the efficacy and efficiency of starting combination antihypertensive treatment versus mono-therapy. The overall evidence supports that initial combination therapy is more effective for many outcomes (ie, reaching blood pressure targets, rapidity of control, patient adherence, and cardiovascular protection assessed by surrogate markers). The few available published clinical trials and observational studies support that the amlodipine + an angiotensin-converting enzyme inhibitor combination may be the most effective for reducing cardiovascular events. We outline a novel algorithm of starting initial therapy with a single tablet containing amlodipine + benazepril in most patients with hypertension regardless of stage or comorbidities. It is our hypothesis that this streamlined approach is likely to yield an overall positive risk/benefit ratio and that it should be tested in an outcome trial versus accepted monotherapies in stage I hypertension.
Robert D Brook; Alan B Weder
Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  5     ISSN:  1933-1711     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-03-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  66-75     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan.
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