Klin Farmakol Farm. 2005;19(3):169-173

Combination therapy for hypertension

Milan Grundmann, Ivana Kacířová

Ústav klinické farmakologie FNsP a ZSF Ostravské univerzity, Ostrava

Current outcomes of antihypertensive therapy remain unsatisfactory since only one in four patients are treated adequately. Most patients with diabetes, stroke and in elderly achieve good compensation of hypertension only using combination therapy. The most commonly used double combinations include diuretics + betalytics, diuretics + ACEI, diuretics + AT1 blockers, and ACEI + calcium channel blockers. Additional options of combination therapy are highlighted in this review. The evidence for double combination use according to evidence based medicine remains inadequate, while for triple combination use there is none. Triple combination drugs are selected based on clinical pharmacology knowledge of their various mechanisms. If triple-combination antihypertensive therapy is unsuccessful, the hypertension is referred to as pharmacoresistant hypertension in which the absence of a diuretic in combination is, however, the commonest mistake.

Keywords: Key words: hypertension, combination therapy, EBM and combination therapy.

Published: January 1, 2006  Show citation