Preview

Systemic Hypertension

Advanced search

The place of fixed antihypertensive drugs in modern therapy of arterial hypertension

https://doi.org/10.26442/2075082X.2020.4.200035

Abstract

The article provides information on modern approaches to the treatment of arterial hypertension. The historical information about therapy with combined antihypertensive drugs is given. Based on data from multicenter clinical trials, the article provides evidence of the benefits of dual and triple fixed drug combinations. Combinations of â1-adrenoreceptor antagonist bisoprolol and the dihydropyridine-type calcium channel blocker amlodipine are considered. The article highlights the advantages of each of the drugs, as well as their combination. It shows the benefits of a fixed combination of low and medium doses compared to high-dose monotherapy, such as efficacy in achieving target blood pressure, preventing cardiovascular events, increasing adherence to treatment, safety and development of side effects. It provides the evidence base for the effectiveness of a triple fixed combination of renin-angiotensin-aldosterone system blockers with calcium channel blockers and diuretics in achieving target blood pressure compared to a double fixed combination of members of these drug classes, which is due to additive effects. The safety and tolerability profiles were found to be more effective with triple therapy compared with dual therapy, which is also supported by studies.

About the Authors

T. V. Pinchuk
Pirogov Russian National Research Medical University
Russian Federation


N. V. Orlova
Pirogov Russian National Research Medical University
Russian Federation


References

1. Düsing R, Waeber B, Destro M. Triple-combination therapy in the treatment of hypertension: a review of the evidence. J Hum Hypertens 2017; 31: 501-10. DOI: 10.1038/jhh.2017.5

2. Gottwald-Hostalek U, Sun N, Barho C. Management of Hypertension With a Fixed-Dose (Single-Pill) Combination of Bisoprolol and Amlodipine. Clin Pharmacol Drug Development 2017; 6 (1): 9-18. DOI: 10.1002/cpdd.309

3. Webster R, Salam A. Fixed Low-Dose Triple Combination Antihypertensive Medication vs Usual Care for Blood Pressure Control in Patients With Mild to Moderate Hypertension in Sri Lanka. JAMA 2018; 320 (6): 566-79. DOI: 10.1001/jama.2018.10359

4. Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet 2015; 386: 801-12. DOI: 10.1016/ S0140-6736(14)61468-9

5. Calhoun DA, Lacourciere Y, Chiang YT, Glazer RD. Triple antihypertensive therapy with amlodipine, valsartan, and hydrochlorothiazide: a randomized clinical trial. Hypertension 2009; 54: 32-9.

6. Oparil S, Melino M, Lee J et al. Triple therapy with olmesartan medoxomil, amlodipine besylate, and hydrochlorothiazide in adult patients with hypertension: The TRINITY multicenter, randomized, double-blind, 12-week, parallel-group study. Clin Ther 2010; 32: 1252-69.

7. Maladkar M, Verma VK, Narsikar KA et al. Triple drug combination of telmisartan, amlodipine and hydrochlorothiazide in the treatment of essential hypertension. OJIM 2012; 2: 67-71.

8. Ferdinand KC, Weitzman R, Israel M et al. Efficacy and safety of aliskiren-based dual and triple combination therapies in US minority patients with stage 2 hypertension. J Am Soc Hypertens 2011; 5: 102-13.


Review

For citations:


Pinchuk T.V., Orlova N.V. The place of fixed antihypertensive drugs in modern therapy of arterial hypertension. Systemic Hypertension. 2020;17(4):44-48. (In Russ.) https://doi.org/10.26442/2075082X.2020.4.200035

Views: 139


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2075-082X (Print)
ISSN 2542-2189 (Online)