The Importance of Drug Combinations for Effective Control of Hypertension

Abstract

The need for drug combinations in the management of hypertension arises from the fact that the majority of hypertensive patients need at least two drugs to control the blood pressure to below 140/90 mmHg. The importance of achieving such goal blood pressures is emphasised by longitudinal studies demonstrating that the achieved blood pressure is the main determinant of outcome and from population surveys in a number of countries that reveal that in general, less than 30% of treated hypertensive patients have blood pressures below 140/90 mmHg.

Good combinations of antihypertensive drugs use agents from different classes with different primary actions so that the hypotensive effects are fully additive while side effects are minimised. The particular value of combining drugs for treating hypertension is that it permits the use of low doses, which in turn improves adherence to therapy and control of hypertension. Effective combinations for the treatment of essential hypertension and of systolic hypertension in the elderly are discussed, as are the potential advantages of fixed low dose combinations.

Key Words:

• Hypertension control in populations
• goals of therapy
• quality of life
• achieved blood pressure
• additive hypotensive effect
• low dose combinations
• fixed low dose combinations