Details

Autor(en) / Beteiligte

• Benjamin, Ivor J
• Kreutz, Reinhold
• Olsen, Michael H
• Schutte, Aletta E
• Lopez-Jaramillo, Patricio
• Frieden, Thomas R
• Sliwa, Karen
• Lackland, Daniel T
• Brainin, Michael

Titel

Fixed-dose combination antihypertensive medications

Ist Teil von

• The Lancet (British edition), 2019-08, Vol.394 (10199), p.637-638

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2019

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Combining two medicines in a single pill can be cost-neutral and has important benefits for patients and for health systems, including improved patient adherence to daily medication regimens, which may improve clinical outcomes;2 improved blood pressure control rates and shortened time to blood pressure control;3 and more efficient hypertension management for health systems by simplifying drug supply and procurement logistics. In an analysis of more than 30 initial dual versus initial monotherapy trials, withdrawals due to adverse events were uncommon with two-drug combinations of a low-to-standard dose, with no significant difference in adverse events compared with those associated with standard-dose monotherapy.3 As organisations with a shared goal of improving hypertension control worldwide, the American Heart Association, European Society of Hypertension, International Society of Hypertension, Lancet Commission on Hypertension Group, Latin American Society of Hypertension, Resolve to Save Lives, World Heart Federation, World Hypertension League, and World Stroke Organization commend WHO for making single-pill combination antihypertensive medications more widely available by including them in the WHO Essential Medicines List. ACC/AHA 2017 ESC/ESH 2018 India 2013 China 2010 Thailand 2015 LASH 2017 WHO HEARTS When to use two blood pressure lowering drugs Not controlled on monotherapy Yes Yes Yes Yes Yes Yes Yes Initial treatment for all individuals No Yes* No No No Yes No Initial treatment for selected individuals, eg, those who are >20/10 mm Hg from goal† or at high cardiovascular risk Yes Yes Yes Yes Yes Yes* Yes When to use single-pill combinations Recommended to substitute for separate pills to improve adherence Yes Yes Yes Yes NR Yes NR Table Selected hypertension guidelines' recommendations for dual combination and fixed-dose combinations