Management of hypertension with fixed-dose triple-combination treatments.
The objective of this review is to evaluate the role of fixed-dose triple-combination therapy for the management of hypertension. An assessment of clinical trials showed that half the patients with hypertension have uncontrolled blood pressure (BP), with underlying factors including therapeutic inertia and poor patient adherence. Many patients will require three antihypertensive agents to achieve BP goals, and current guidelines recommend combining drugs with complementary mechanisms of action. Three single-pill triple-combination treatments are available and each includes an agent affecting the renin-angiotensin-aldosterone pathway (either a direct renin inhibitor or an angiotensin II receptor blocker) in combination with a calcium channel blocker and diuretic. These triple-combination therapies consistently demonstrated significantly greater BP reduction relative to the component dual combinations, with BP reductions documented across a range of patient populations. Triple-combination treatments were well tolerated in all clinical trials reviewed. The use of single-pill, triple-combination antihypertensive therapy has been shown to be an effective, well-tolerated, and convenient treatment strategy that can help patients achieve BP control.
University of Florida College of Pharmacy, Department of Pharmacotherapy and Translational Research, PO Box 100486, 1600 SW Archer Road, Gainesville, FL 32610, USA.
Benjamin J
BJ
Epstein
Niren K
NK
Shah
Nancy L
NL
Borja-Hart
D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004232:Diuretics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D004338:Drug Combinations
aliskiren; amlodipine; antihypertensive agents; drug combinations; fixed-dose triple-combination therapy; hydrochlorothiazide; hypertension; olmesartan; valsartan