Epstein Benjamin J, Shah Niren K, Borja-Hart Nancy L
University of Florida College of Pharmacy, Department of Pharmacotherapy and Translational Research, PO Box 100486, 1600 SW Archer Road, Gainesville, FL 32610, USA.
Ther Adv Cardiovasc Dis. 2013 Oct;7(5):246-59. doi: 10.1177/1753944713498638. Epub 2013 Aug 14.
The objective of this review is to evaluate the role of fixed-dose triple-combination therapy for the management of hypertension. An assessment of clinical trials showed that half the patients with hypertension have uncontrolled blood pressure (BP), with underlying factors including therapeutic inertia and poor patient adherence. Many patients will require three antihypertensive agents to achieve BP goals, and current guidelines recommend combining drugs with complementary mechanisms of action. Three single-pill triple-combination treatments are available and each includes an agent affecting the renin-angiotensin-aldosterone pathway (either a direct renin inhibitor or an angiotensin II receptor blocker) in combination with a calcium channel blocker and diuretic. These triple-combination therapies consistently demonstrated significantly greater BP reduction relative to the component dual combinations, with BP reductions documented across a range of patient populations. Triple-combination treatments were well tolerated in all clinical trials reviewed. The use of single-pill, triple-combination antihypertensive therapy has been shown to be an effective, well-tolerated, and convenient treatment strategy that can help patients achieve BP control.
本综述的目的是评估固定剂量三联疗法在高血压管理中的作用。对临床试验的评估表明，一半的高血压患者血压控制不佳，潜在因素包括治疗惰性和患者依从性差。许多患者需要三种抗高血压药物才能实现血压目标，当前指南建议联合使用具有互补作用机制的药物。有三种单片三联组合疗法可供选择，每种疗法都包括一种影响肾素-血管紧张素-醛固酮途径的药物（直接肾素抑制剂或血管紧张素II受体阻滞剂），与钙通道阻滞剂和利尿剂联合使用。与组成双联组合相比，这些三联组合疗法始终显示出显著更大的血压降低效果，在一系列患者群体中均有血压降低的记录。在所有纳入综述的临床试验中，三联组合疗法耐受性良好。使用单片三联抗高血压疗法已被证明是一种有效、耐受性良好且方便的治疗策略，可帮助患者实现血压控制。
