The use of fixed dose combinations in the treatment of hypertension — resistant hypertension or patient resistant to treatment?

Abstract

Resistant hypertension (RH) is defined as a condition in which blood pressure remains above 140/90 mm Hg despite the use of at least three antihypertensive drugs, correctly combined and in full doses (including a diuretic). In Poland, the percentage of people suffering from RH is estimated at 10–13% relative to the total number of patients with hypertension. On the other hand, in recent years we have seen a significant increase in the importance of combination products both in Europe and in the United States. Several studies have shown that therapy that includes an average of 3 antihypertensive agents (in the form of combination products) having different mechanisms of action, such as blockers of the renin-angiotensin-aldosterone system (RAAS) in combination with a calcium channel blocker (CCB) or a diuretic, provides blood pressure control in the majority of patients, not only through increased efficacy and tolerability of drugs, but also owing to the simplification of the therapeutic regimen, which promotes the compliance with medical recommendations. In this paper we present the case of a patient with resistant hypertension, whose blood pressure normalised only after the use of a combination product.