When antihypertensive monotherapy fails: Fixed-dose combination therapy

Background. Antihypertensive monotherapy fails to control blood pressure in many patients. Methods. Data on the efficacy and tolerance of fixed dose angiotensin-conve rting enzyme (ACE) inhibitor/calcium antagonist combinations were reviewed, since they are the most widely prescribed medications for hypertension. Results. A fixed-dose combination of two drug classes is an option for hype rtension treatment. Four fixed-dose ACE inhibitor/calcium antagonist combin ations are available. They achieve superior blood pressure control with no increase in adverse events compared with their monotherapy components. In a ddition, they antagonize some class-specific adverse effects and may exhibi t beneficial effects on target organ disease, such as renal dysfunction and left ventricular hypertrophy. Conclusions. Fixed-dose combination therapy is an attractive option when re asonable doses of initial antihypertensive monotherapy fail. Use of such co mbinations could increase patient compliance, by virtue of better tolerance compared with increased-dose monotherapy and simplicity of administration.