RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITION - PHARMACOLOGICAL RATIONALE AND EVALUATION OF DRUG-COMBINATIONS

First-line antihypertensive monotherapy is effective in normalizing bl ood pressure in approximately 50 per cent of patients. Normalization i n the remaining patients may require a combination of two or more drug s. This review considers the rationale and the evaluation of combinati ons with drugs interacting with the renin-angiotensin system (i.e angi otensin-converting enzyme inhibitors (ACEI) and angiotensin receptor a ngonists) with other drugs. The combinations may be justified when giv ing an additive or synergistic action and when reducing clinical or me tabolic side-effects. Recent developments concern the potential benefi t of combining ACEI and angiotensin receptor antagonists.