Rationale for fixed-dose combinations in the treatment of hypertension: the cycle repeats

Domenic A Sica


Single-drug therapy remains the preferred way to begin treatment of hypertension, although in many patients this is unable to bring blood pressure (BP) to goal levels. Single-drug therapy, even when maximally titrated, is at best only modestly effective in normalising BP in Stage-I or II hypertension, which represents the majority of the hypertensive population. It is increasingly appreciated that the elusive goal of a 'normal' BP is achieved only if multi-drug therapy is employed. This is especially so when considered in the context of today's lower BP goals. The options for multi-drug therapy are quite simple: either fixed-dose combination therapy or drugs added sequentially one after another to then arrive at an effective multi-drug regimen. Advocates exist for both approaches. A considerable legacy, dating to the 1950's, exists for fixed-dose combination therapies. The rationale to this approach has remained constant. Fixed-dose combination therapy successfully reduces BP because two drugs, each typically working at a separate site, block different effector pathways. In addition, the second drug of such two-drug combinations may check counter-regulatory system activity triggered by the other. For example, a diuretic and bet...Continue Reading


Jan 1, 1977·Annual Review of Pharmacology and Toxicology·C T Dolley
Jun 1, 1991·Journal of Medicinal Chemistry·F P GuengerichP Berntsson
Sep 1, 1990·Archives of Internal Medicine·S A EisenT R Przybeck
Jan 1, 1987·British Journal of Clinical Pharmacology·E AmbrosioniF V Costa
Jan 1, 1981·European Journal of Clinical Pharmacology·J C RoosE J Dorhout Mees
Feb 1, 1981·British Journal of Clinical Pharmacology·L E Ramsay, J Hettiarachchi
Oct 1, 1981·The American Journal of Medicine·G MaschioL Minetti
Feb 27, 1995·Archives of Internal Medicine·M A WeberE B Nelson
Jul 11, 1994·Archives of Internal Medicine·R R Fenichel, R J Lipicky
Jul 11, 1994·Archives of Internal Medicine·T C Fagan
Aug 1, 1993·Journal of Clinical Pharmacology·W H FrishmanA Cretkovic
Jun 30, 1994·The New England Journal of Medicine·D S SiscovickE H Wagner
Sep 30, 1996·The American Journal of Medicine·J M NeutelM A Weber
Oct 1, 1996·Journal of Clinical Pharmacology·L M Prisant, G A Mensah
May 12, 1997·Archives of Internal Medicine·J L Wofford
Mar 1, 1997·Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension·H Holzgreve

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Jun 15, 2004·Neuroreport·Aileen I Pogue, Walter J Lukiw
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