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Fixed dose combination therapy in the treatment of hypertension

Journal of Human Hypertension volume 16, pages 75–78 (2002)Cite this article

Raised blood pressure is a common and quantitatively important cardiovascular risk factor. Over 50% of over 65’s in industrialised countries may be considered to have hypertension1 and 50% of people in this age group go on to die a cardiovascular death such as myocardial infarct or stroke.2 Studies have clearly demonstrated the benefit and safety of an aggressive strategy of blood pressure lowering with targets of below 140 mm Hg systolic and 90 mm Hg diastolic.3 Hypertension-induced stroke appears to be largely preventable and a significant reduction is seen in hypertension-attributable ischaemic heart disease when the above targets are achieved.4 Reaching and maintaining these targets in the majority of patients however presents a clinical challenge.

Currently several drug classes can be utilised in the treatment of hypertension: thiazide diuretics, beta (β)-blockers, calcium channel blockers (CCB's), angiotensin-converting enzyme (ACE) inhibitors, angiotensin II (AII) receptor blockers, alpha (α) blockers and centrally acting agents. Both the British Hypertension Society 1999 guidelines5 and the American 6th Joint National Committee on Prevention, Detection, Evaluation, and Treatment of Blood Pressure (JNC VI) of 19976 recommend that, in the absence of contra-indications or compelling indications for other agents, thiazide diuretics and β-blockers are the drugs of choice. These drugs have proved to be both safe and efficacious in numerous randomised control trials. Practice has been to begin treatment with one of these agents as monotherapy at a low dose. If this does not control blood pressure adequately then the physician is faced with three options.

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  1. Department of Medicine and Therapeutics, University of Glasgow, Glasgow, Scotland, UK

    T Stanton & J L Reid

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  1. T Stanton
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Correspondence to J L Reid.

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Stanton, T., Reid, J. Fixed dose combination therapy in the treatment of hypertension. J Hum Hypertens 16, 75–78 (2002). https://doi.org/10.1038/sj.jhh.1001312

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