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 language | English |
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Pages (from-to) | 253-260 |
Number of pages | 8 |
Journal | Vascular Health and Risk Management |
Volume | 6 |
Issue number | 1 |
Publication status | Published - 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