Rochlani Yogita, Khan Mohammed Hasan, Banach Maciej, Aronow Wilbert S
a Cardiology Division, Department of Medicine , New York Medical College , Valhalla , NY , USA.
b Department of Hypertension, Divisions of Nephrology and Hypertension , MUL , Lodz , Poland.
Expert Opin Pharmacother. 2017 Mar;18(4):377-386. doi: 10.1080/14656566.2017.1288719. Epub 2017 Feb 8.
Current guidelines for pharmacotherapy briefly describe a role for combination antihypertensive therapy. However, guidance on whether combination therapy should be used at the time of initiating therapy or as add on, and the choice of combination therapy is scarce. Areas covered: Current literature suggests that intensive blood pressure control is the key to managing cardiovascular risk. Along with lifestyle management, pharmacotherapy is an central component in the treatment of hypertension. Here, we aim to review the pathophysiology of hypertension, rationale for using combination therapy, and the different combinations of antihypertensive drug classes that are available in the market. Papers from 1967 through 2016 listed on PubMed on this topic were reviewed. Expert opinion: Based on the review of the literature, combination antihypertensive therapies are more effective than monotherapy and are also well tolerated, safe and cost effective for treatment of hypertension. Further research is needed to help guide the choice of combination antihypertensive therapy in different patient populations based on age, gender, race and comorbidities.
当前的药物治疗指南简要描述了联合抗高血压治疗的作用。然而，关于联合治疗应在起始治疗时使用还是作为附加治疗，以及联合治疗的选择方面的指导却很匮乏。涵盖领域：当前文献表明，强化血压控制是管理心血管风险的关键。除生活方式管理外，药物治疗是高血压治疗的核心组成部分。在此，我们旨在综述高血压的病理生理学、使用联合治疗的原理，以及市场上可用的不同抗高血压药物类别的联合方式。对1967年至2016年在PubMed上列出的关于该主题的论文进行了综述。专家意见：基于文献综述，联合抗高血压治疗比单一疗法更有效，并且在治疗高血压方面耐受性良好、安全且具有成本效益。需要进一步研究以帮助根据年龄、性别、种族和合并症来指导不同患者群体联合抗高血压治疗的选择。
