Hypertension is an extremely common condition and quantitatively the most important risk factor for cardiovascular disease and mortality. Cardiovascular risk factors other than hypertension occur more frequently in hypertensive subjects and contribute to the elevated cardiovascular risk. Management of hypertensive subjects includes lifestyle modification and, usually, treatment with antihypertensive agents. Due to the limited blood pressure lowering effect of a single antihypertensive agent, more than 2/3 of hypertensive patients require at least two or more antihypertensive agents to achieve target blood pressure. For combination therapy combining an agent that interferes with the renin-angiotensin system with an agent that does not is recommended. Treatment adherence and persistence can be improved by using fixed-dose combinations instead of single agents.
A global approach to hypertension
Division of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands