Role of valsartan, amlodipine and hydrochlorothiazide fixed combination in blood pressure control: An update

Maurizio Destro, Francesca Cagnoni, Antonio D'Ospina, Alessandra Rossi Ricci, Elena Demichele, Emmanouil Peros, Augusto Zaninelli, Paola Preti

Research output: Contribution to journalArticlepeer-review

Abstract

The treatment of moderate or severe hypertension in most cases requires the contemporaneous use of multiple antihypertensive agents. The most available two-drug combinations have an agent that addresses renin secretion and another one that is statistically more effective in renin-independent hypertension. The practice of combining agents that counteract different mechanisms is the most likely explanation for the fact that most available two-drug combinations have an agent that addresses renin secretion (beta-blocker, angiotensin converting enzyme inhibitor, angiotensin II receptor blocker or direct renin inhibitor) and another one that is more effective in renin-independent hypertension (diuretic, dihydropyridine or non-dihydropyridine calcium channel blocker). Based on these considerations, addition of hydrochlorothiazide to the combination of an antagonist of the renin-angiotensin system with a calcium channel blocker would constitute a logical approach. Inclusion of a diuretic in the triple combination is based on the evidence that these agents are effective and cheap, enhance the effect of other antihypertensive agents, and add a specific effect to individuals with salt-sensitivity of blood pressure. The benefit of triple combination therapy with amlodipine, valsartan and hydrochlorothiazide over its dual component therapies has been demonstrated, and the use of a single pill will simplify therapy resulting in better blood pressure control.

Original languageEnglish
Pages (from-to)253-260
Number of pages8
JournalVascular Health and Risk Management
Volume6
Issue number1
Publication statusPublished - 2010

Keywords

  • Amlodipine
  • Blood pressure
  • HCTZ
  • Hydrochlorothiazide
  • Hypertension
  • Valsartan

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)
  • Public Health, Environmental and Occupational Health
  • Hematology
  • Endocrinology, Diabetes and Metabolism

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