Selecting drugs to treat hypertension: is a combination approach more effective?

This study reviewed published reports on the use of combination treatments for hypertension.

They found that using a combination of drugs can be effective and should be tailored to specific types of hypertension.

Hypertension (high blood pressure) is a serious condition that is a leading cause of death. Management of hypertension may involve the use of one or more medications. There are a number of different classes (types) of drug including beta-blockers, angiotensin-receptor blockers, thiazides and calcium channel blockers. However, the first-line treatment is usually one treatment alone. If that treatment is not successful, one other treatment alone may be tried. Combinations of therapies may not be used until single treatments have been tried. Using a combination of drugs to treat hypertension may be more successful.

This study reviews and comments on the when certain anti-hypertensive strategies are most useful.

This study included reports and recommendations from over 40 sources. The review was performed based on drug type and mode of action. Results from clinical trials were compared and considered.

Combination drug treatments can effectively manage blood pressure compared to monotherapy (single drug). When compared to increasing the dose of a single drug, combination therapy led to 5 times the decrease in blood pressure. In patients with mild hypertension, combination treatment from the start lowered the risk of cardiovascular events (such as heart attack). Resistant hypertension remains uncontrolled even with four treatments. Studies are needed to determine whether combination therapy from the start is beneficial for this type of hypertension.

There was no specific drug combination that was most effective. The most successful outcome is achieved by tailoring medication strategies to the individual patient. 

This study concluded that a combination of drugs can be effective, and the treatment combination should be tailored to specific types of hypertension.

Some of the reports reviewed in this study have different designs. Comparing the results from these trials may not be the most appropriate analysis of how well certain combinations work.

If you have any concerns regarding blood pressure management, please discuss this with your physician.