Fixed-dose Hypotensive Combination — differencesses and similarities. New Possibilities in the Choice of the First Line Hypertension Treatments

Abstract

Redusing blood pressure by pharmacological means clearsly reduces cardiovascular morbidity and mortality rate.
However, keeping patiens on treatment and treating to a goal blood pressure are difficult in practice, and only 6% to 27% of hypertensive patients are controlled in different countries. The majority of antihypertensive drugs administered as monotherapy have similar overall efficacy close to 50%. An alternative strategy to monotherapy is therefore to prescribe two drugs with diffirent modes of action. Lowdose, fixed combination therapy can be used in place of monotherapy as initial hypertension treatment. The recent JNC VI Report, WHO/ISH and PTNT guidelines recommends the use of combination therapy, especially with low-dose diuretics in hypotensive therapy initation.
The advantage of this approach is that low doses of drugs that act by different mechanisms may have additive or synergistic effects on blood pressure with minimal-dose-dependent adverse effects.