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Editorial Comment
The role of combination therapy in the management of hypertension
Orange County Research Center, Tustin, CA, USA
Correspondence and offprint requests to: Joel M. Neutel, Orange County Research Center, Tustin, CA, USA. Email: JMNeutel@aol.com
Keywords: angiotensin receptor blockers; combination therapy; goal blood pressure
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The relationship of blood pressure and cardiovascular risk |
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Data from the largest meta-analysis of hypertensive patients clearly demonstrate that increasing systolic blood pressure (BP) in any age group is associated with very significant increases in cardiovascular disease [1]. It has been shown that for every 20 mmHg increase in systolic BP, or for every 10 mmHg increase in diastolic BP, there is a doubling in the risk of cardiovascular disease. Conversely, a meta-analysis of outcome studies in the treatment of systolic hypertension demonstrated that for every 20 mmHg reduction in systolic BP there is an
40–45% reduction in cardiovascular disease [2]. These studies have confirmed the very significant cardiovascular risk associated with hypertension and the impressive benefits that can be derived from the treatment of this disease process. Despite these findings, worldwide epidemiological data have shown that fewer than one-third of hypertensive patients achieve a BP of <140/90 mmHg [3].
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The blood pressure values achieved in clinical practice |
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Perhaps of
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Reasons for inadequate blood pressure control |
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The solution: combination therapy—greater efficacy |
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Combination therapy—fewer side effects |
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The role of fixed combinations |
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‘Overtreatment’—a legitimate concern? |
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Conclusion |
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