Angiotensin II receptor blocker combinations: From guidelines to clinical practice

被引:3
作者
Narkiewicz, Krzysztof [1 ]
机构
[1] Med Univ Gdansk, Dept Hypertens & Diabetol, PL-80952 Gdansk, Poland
关键词
amlodipine; angiotensin II type receptor blocker; guidelines; hydrochlorothiazide; hypertension; olmesartan; BLOOD-PRESSURE CONTROL; FIXED-DOSE COMBINATIONS; OLMESARTAN MEDOXOMIL; DOUBLE-BLIND; ANTIHYPERTENSIVE EFFICACY; HYPERTENSION TREATMENT; AMLODIPINE BESYLATE; TREATMENT ALGORITHM; HIGH-RISK; THERAPY;
D O I
10.3109/08037051.2011.598700
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
European guidelines recommend a combination of at least two antihypertensive drugs to achieve blood pressure (BP) goals in the majority of patients. In addition, they encourage simplification of treatment regimens using single-pill, fixed-dose combinations (FDCs) to aid compliance. Of the preferred combinations, those based on angiotensin II receptor blockers (ARBs) may be more desirable than those based on angiotensin-converting enzyme inhibitors, because of equivalent efficacy and superior tolerability. Significantly better BP reductions and control rates have been observed with the dual combinations of ARBs with amlodipine or hydrochlorothiazide (HCZT) compared with component monotherapies. Furthermore, in the 15-20% of patients who require triple combination therapy to achieve BP goals, fixed-dose triple combinations with an ARB, calcium-channel blocker and diuretic, which have recently become available, provide significantly better BP reductions and control compared with dual combinations. Within the ARB class, olmesartan stands out as being one that has been recently investigated in a considerable number of studies that are relevant to the modern concept of FDC therapy in terms of both dual and triple combination therapy. The availability of such single-pill FDCs has the potential to deliver strong antihypertensive efficacy with good tolerability and improved compliance.
引用
收藏
页码:73 / 81
页数:9
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