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2024-08-01

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cc-by (c) Coca, Antonio et al., 2024
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/229176

Single-pill combination for treatment of hypertension: Just a matter of practicality or is there a real clinical benefit?

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Recurs relacionat

https://doi.org/10.1016/j.ejim.2024.04.011

Resum

Abstract Elevated blood pressure (BP) is the largest contributor to the incident cardiovascular disease worldwide. Despite explicit guideline recommendations for the diagnosis and management of hypertension, a large proportion of patients remain undiagnosed, untreated, or treated but uncontrolled. Inadequate BP control is associated with many complex factors including patient preference, physician's inertia, health systems disparities, and poor adherence to prescribed antihypertensive drug treatment. The primary driver for reduced cardiovascular morbidity and mortality is lowering of BP ‘‘per se’’ and not class effects of specific pharmacotherapies. The recent ESH guidelines recommend the use of four major classes of drugs including renin‐angiotensin‐aldosterone system (RAS) blockers (angiotensin receptor blockers (ARB) or angiotensin‐converting enzyme inhibitors (ACEi)), calcium channel blockers (CCB), thiazide and thiazide‐like diuretics, and betablockers. Initiation of treatment for hypertension with a two-drug regimen, preferably in a single pill combination (SPC), is recommended for most patients. Preferred combinations should comprise a RAS blocker (either an ACEi or an ARB) with a CCB or thiazide/thiazide-like diuretic. These strategies are supported by robust evidence that combination therapy produces greater BP reductions than monotherapy, reduces side effects of the individual components, improves therapeutic adherence and long-term persistence on treatment, and permits achievement of earlier BP control.

Matèries

Hipertensió, Terapèutica

Matèries (anglès)

Hypertension, Therapeutics

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

COCA, Antonio, et al. Single-pill combination for treatment of hypertension: Just a matter of practicality or is there a real clinical benefit?. European Journal Of Internal Medicine. 2024. Vol. 126, núm. 16-25. ISSN 0953-6205. [consulta: 8 de maig de 2026]. Disponible a: https://hdl.handle.net/2445/229176

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