Combination therapy in hypertension

被引:177
作者
Gradman, Alan H. [1 ,2 ]
Basile, Jan N. [3 ]
Carter, Barry L. [4 ]
Bakris, George L. [5 ]
机构
[1] Western Penn Hosp, Dept Med, Pittsburgh, PA 15224 USA
[2] Temple Univ, Sch Med, Philadelphia, PA 19122 USA
[3] Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA
[4] Univ Iowa, Roy J & Lucille A Carver Coll Med, Iowa City, IA USA
[5] Univ Chicago, Pritzker Sch Med, Chicago, IL 60637 USA
关键词
Hypertension; combination therapy; drug therapy; angiotensin converting enzyme inhibitor; angiotensin receptor blocker; beta blockers diuretic; calcium channel blocker; LOW-DOSE HYDROCHLOROTHIAZIDE; FELODIPINE EXTENDED-RELEASE; BLOOD-PRESSURE CONTROL; DOUBLE-BLIND; ANTIHYPERTENSIVE TREATMENT; RANDOMIZED-TRIAL; BETA-BLOCKERS; HIGH-RISK; MONOTHERAPY; AMLODIPINE;
D O I
10.1016/j.jash.2010.02.005
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
The goal of antihypertensive therapy is to abolish the risks associated with blood pressure (BP) elevation without adversely affecting quality of life. Drug selection is based on efficacy in lowering BP and in reducing cardiovascular (CV) end points including stroke, myocardial infarction, and heart failure. Although the choice of initial drug therapy exerts some effect on long-term outcomes, it is evident that BP reduction per se is the primary determinant of CV risk reduction. Available data suggest that at least 75% of patients will require combination therapy to achieve contemporary BP targets, and increasing emphasis is being placed on the practical tasks involved in consistently achieving and maintaining goal BP in clinical practice. It is within this context that the American Society of Hypertension presents this Position Paper on Combination Therapy for Hypertension. It will address the scientific basis of combination therapy, present the pharmacologic rationale for choosing specific drug combinations, and review patient selection criteria for initial and secondary use. The advantages and disadvantages of single pill (fixed) drug combinations, and the implications of recent clinical trials involving specific combination strategies will also be discussed. J Am Soc Hypertens 2010;4(1):42-50. (C) 2010 American Society of Hypertension. All rights reserved.
引用
收藏
页码:42 / 50
页数:9
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