When antihypertensive monotherapy fails: fixed-dose combination therapy.
BACKGROUND
Antihypertensive monotherapy fails to control blood pressure in many patients.


METHODS
Data on the efficacy and tolerance of fixed dose angiotensin-converting enzyme (ACE) inhibitor/calcium antagonist combinations were reviewed, since they are the most widely prescribed medications for hypertension.


RESULTS
A fixed-dose combination of two drug classes is an option for hypertension treatment. Four fixed-dose ACE inhibitor/calcium antagonist combinations are available. They achieve superior blood pressure control with no increase in adverse events compared with their monotherapy components. In addition, they antagonize some class-specific adverse effects and may exhibit beneficial effects on target organ disease, such as renal dysfunction and left ventricular hypertrophy.


CONCLUSIONS
Fixed-dose combination therapy is an attractive option when reasonable doses of initial antihypertensive monotherapy fail. Use of such combinations could increase patient compliance, by virtue of better tolerance compared with increased-dose monotherapy and simplicity of administration.
Weir
M R
MR
Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers