Barrios Vivencio, Escobar Carlos
Department of Cardiology, Hospital Ramón y Cajal, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, Spain.
Expert Rev Cardiovasc Ther. 2010 Nov;8(11):1609-18. doi: 10.1586/erc.10.115.
A significant proportion of patients with hypertension will need three or more antihypertensive agents to achieve blood pressure goals, particularly those at higher risk. On the other hand, fixed combinations provide an extra beneficial effect, as they improve medication adherence and, secondarily, the attainment of blood pressure goals during follow-up. Triple therapy is recommended in the treatment of hypertension in those patients not adequately controlled with two antihypertensive drugs. In this context, guidelines recommend the combination of a renin-angiotensin system inhibitor, a calcium channel blocker and a diuretic. The triple fixed combination of valsartan-amlodipine-hydrochlorothiazide has been shown to be an effective and safe therapy for treating hypertension and seems a logical approach for those patients uncontrolled with two antihypertensive agents as well as in those patients already treated with three drugs to improve treatment compliance. In this article, available evidence about the efficacy and tolerability of the triple fixed combined therapy valsartan-amlodipine-hydrochlorothiazide for the treatment of hypertension is updated.
相当一部分高血压患者需要三种或更多种抗高血压药物才能实现血压目标，尤其是那些风险较高的患者。另一方面，固定复方制剂具有额外的有益效果，因为它们可提高用药依从性，其次，在随访期间有助于实现血压目标。对于使用两种抗高血压药物仍未得到充分控制的高血压患者，建议采用三联疗法。在此背景下，指南推荐联合使用肾素-血管紧张素系统抑制剂、钙通道阻滞剂和利尿剂。缬沙坦-氨氯地平-氢氯噻嗪三联固定复方制剂已被证明是一种治疗高血压的有效且安全的疗法，对于使用两种抗高血压药物仍未得到控制的患者以及已经使用三种药物治疗的患者而言，这似乎是一种合理的提高治疗依从性的方法。在本文中，更新了关于缬沙坦-氨氯地平-氢氯噻嗪三联固定复方疗法治疗高血压的疗效和耐受性的现有证据。
