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


METHODS
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.


CONCLUSIONS
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.
New York University School of Medicine, The Leon H Charney Division of Cardiology, Cardiac Catheterization Laboratory , NY 10016 , USA. sripalbangalore@gmail.com
Sripal
S
Bangalore
Ludwin
L
Ley
D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D055118:Medication Adherence; D018570:Risk Assessment; D012307:Risk Factors; D013607:Tablets; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D004338:Drug Combinations; D013607:Tablets