Improving treatment adherence to antihypertensive therapy: the role of single-pill combinations

Abstract

Introduction: The majority of patients with hypertension require combination therapy to achieve their blood pressure (BP) goal. Studies have consistently shown that polypharmacy and complex treatment regimens have a detrimental effect on treatment compliance, adherence and persistence (herein referred to as treatment adherence).

Areas covered: This paper reviews the available clinical evidence, as well as guidelines, which propose combinations of an angiotensin II receptor blocker (ARB) or an angiotensin-converting enzyme (ACE) inhibitor plus a calcium channel blocker (CCB) or diuretic.

Expert opinion: ARBs are associated with better tolerability compared with ACE inhibitors, and data suggest that ARB/CCB combinations may be better tolerated than CCB monotherapy. The use of true once-daily single-pill combination therapy with effective and well-tolerated agents will reduce pill burden, simplify treatment regimens and improve treatment adherence, which will, in turn, help patients to reach and maintain their BP target and achieve the short- and long-term treatment goal of cardiovascular risk reduction.

Keywords:

• adherence
• antihypertensives
• compliance
• hypertension control
• persistence
• single-pill combination therapy

Acknowledgement

S Bangalore is a consultant for Daiichi-Sankyo and Boehringer Ingelheim. L Ley is an employee of Boehringer Ingelheim. The authors received no compensation related to the development of the manuscript. Writing and editorial assistance was provided by Lisa Buttle, PhD, of PAREXEL, which was contracted by Boehringer Ingelheim International GmbH for these services.

Notes

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