HYPERTENSION - THE REDISCOVERY OF COMBINATION THERAPY

Awareness and treatment of hypertension in the United States has been improving for older patients, but hypertension continues in many cases to be poorly controlled. Three options exist if initial therapy fails to achieve target blood pressure: upward drug titration, substituting another drug, or combination drug therapy. Combination therapy is the attempt to optimize blood pressure control by using two or more agent s with additive or synergistic effects. Problems with this approach in clude noncompliance due to complicated regimens, adverse drug reaction s, and the added expense of multiple medications. However, the newer f ixed-dose combination products have been shown to offer improved blood pressure control, simplification of drug regimens, decreased adverse reactions, improved compliance, and cost-effectiveness.