Rationale for triple fixed-dose combination therapy with an angiotensin II receptor blocker, a calcium channel blocker, and a thiazide diuretic Full Text
Vascular Health and Risk Management,  Clinical Article

Volpe M et al. – The availability of these fixed–dose combinations should lead to improvement in blood pressure control and aid compliance with long–term therapy, optimizing the management of this chronic condition.

  • Hypertension is a growing global health problem, and is predicted to affect 1.56 billion people by 2025.
  • Treatment remains suboptimal, with control of blood pressure achieved in only 20%–35% of patients, and the majority requiring two or more antihypertensive drugs to achieve recommended blood pressure goals.
  • To improve blood pressure control, the European hypertension guidelines recommend that angiotensin II receptor blockers (ARBs) or angiotensin–converting enzyme inhibitors (ACEIs) are combined with calcium channel blockers (CCBs) and/or thiazide diuretics.
  • The rationale for this strategy is based, in part, on their different effects on the renin–angiotensin system, which improves antihypertensive efficacy.
  • Data from a large number of trials support the efficacy of ACEIs or ARBs in combination with CCBs and/or hydrochlorothiazide (HCTZ).
  • Combining two different classes of antihypertensive drugs has an additive effect on lowering of blood pressure, and does not increase adverse events, with the ARBs showing a tolerability advantage over the ACEIs.
  • Among the different ARBs, olmesartan medoxomil is available as a dual fixed–dose combination with either amlodipine or HCTZ, and the increased blood pressure–lowering efficacy of these two combinations is proven.
  • Triple therapy is required in 15%–20% of treated uncontrolled hypertensive patients, with a renin–angiotensin system blocker, CCB, and thiazide diuretic considered to be a rational combination according to the European guidelines.
  • Olmesartan, amlodipine, and HCTZ are available as a triple fixed–dose combination, and significant blood pressure reductions have been observed with this regimen compared with the possible dual combinations.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

    Currently, there are no available articles.

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Medical Student Articles

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More