FIXED DRUG-COMBINATIONS IN THE TREATMENT OF HYPERTENSION - HOW TO IDENTIFY THE OPTIMAL DOSE

Rationale for drug combinations The most common reason for combining d ifferent drugs is to achieve an additional fall in arterial pressure. It therefore seems reasonable to combine drugs with different mechanis ms of actions. Need for clinical trials However, the effects of combin ation therapy on the heart and other target organs remains poorly docu mented. Most of what we know with regard to combination therapy on hyp ertensive heart disease is based on extrapolation from monotherapy. Th e fact that two drugs when used separately are beneficial in a disorde r does not necessarily imply that their combination is equally or more beneficial in the same disorder. Thus, it will become important to es tablish efficacy and safety of new drug combinations on hypertensive t arget organs and on morbidity and mortality by performing carefully de signed clinical trials. (C) 1998 Rapid Science Ltd.