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High Blood Press Cardiovasc Prev. 2017 Dec;24(4):463-472. doi: 10.1007/s40292-017-0239-7. Epub 2017 Oct 31.

Personalised Single-Pill Combination Therapy in Hypertensive Patients: An Update of a Practical Treatment Platform.

Author information

1
Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Via di Grottarossa 1035-39, 00189, Rome, Italy. massimo.volpe@uniroma1.it.
2
IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, Isernia, Italy. massimo.volpe@uniroma1.it.
3
Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Via di Grottarossa 1035-39, 00189, Rome, Italy.
4
IRCCS Neuromed, Via Atinense, 18, 86077, Pozzilli, Isernia, Italy.
5
Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain.
6
Department of Clinical Pharmacology and Toxicology, Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany.
7
Corporate Member of Freie Universität Berlin, Berlin, Germany.
8
Humboldt-Universität zu Berlin, Berlin, Germany.
9
Berlin Institute of Health, Berlin, Germany.
10
Department of Pharmacology and INSERM U 970, European Georges Pompidou Hospital, Université Paris-Descartes and Assistance Publique Hôpitaux de Paris, 56 rue Leblanc, 75015, Paris, France.
11
Department of Cardiology, Asclepeion General Hospital, Athens, Greece.
12
Hippokration Hospital, National and Kapodistrian University of Athens, Vas Sofias 114, 11527, Athens, Greece.

Abstract

Despite the improvements in the management of hypertension during the last three decades, it continues to be one of the leading causes of cardiovascular morbidity and mortality worldwide. Effective and sustained reductions in blood pressure (BP) reduce the incidence of myocardial infarction, stroke, congestive heart failure and cardiovascular death. However, the proportion of patients who achieve the recommended BP goal (< 140/90 mmHg) is persistently low, worldwide. Poor adherence to therapy, complex therapeutic regimens, clinical inertia, drug-related adverse events and multiple risk factors or comorbidities contribute to the disparity between the potential and actual BP control rate. Previously we published a practical therapeutic platform for the treatment of hypertension based on clinical evidence, guidelines, best practice and clinical experience. This platform provides a personalised treatment approach and can be used to improve BP control and simplify treatment. It uses long-acting, effective and well-tolerated angiotensin receptor blocker (ARB) olmesartan, in combination with a calcium channel blocker amlodipine, and/or a thiazide diuretic hydrochlorothiazide. These drugs were selected based on the availability in most European Countries of single-pill, fixed formulations in a wide range of doses for both dual- and triple-drug combinations. The platform approach could be applied to other ARBs or angiotensin-converting enzyme inhibitors available in single-pill, fixed-dose combinations. Here, we present an update, which takes into account the results of the recently published studies and extends the applicability of the platform to common conditions that are often neglected or poorly considered in clinical practice guidelines.

KEYWORDS:

Angiotensin receptor blockers; Angiotensin-converting enzyme inhibitors; Antihypertensive therapy; Calcium channel blockers; Hypertension; Olmesartan medoxomil

PMID:
29086364
PMCID:
PMC5681620
DOI:
10.1007/s40292-017-0239-7
[Indexed for MEDLINE]
Free PMC Article

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