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Combination therapy in managing hypertension-an overview

Int J Biol Med Res. 2014; 5(3): 4414-4420  |  PDF File


Hypertension is a condition that involves multiple body organs and physiological systems. Maintaining blood pressure (BP) by using one class of drugs that affect one or two systems usually have inadequate response and result in a compensatory or counter- regulatory response from others to blunt the targeted effect of individual drug. For example, starting with diuretics result in initially decrease in intravascular volume, this trigger Renin-Angiotensin-Aldosterone System which cause vaso constriction and salt retention. In most cases monotherapy failed to achieve the goal and results in various side effects because of high dosing of individual drug (2). Starting with low dose combination therapy of two or more drugs affecting multiple physiologic systems and having additive effects may result in better control of BP with less side effects (2, 6). It is also emphasized that available data show that combination therapy is more effective and has achieved targeted BP earlier then monotherapy (2, 7). It is concluded from the data that about 70-75% hypertensive patients require combination therapy.