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Drug Adherence in Hypertension and Cardiovascular Protection pp 225–235Cite as

Use of Fixed-Dose Combinations in Hypertension and Cardiovascular Disease Prevention

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Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

Abstract

In spite of the wide availability of effective and well-tolerated antihypertensive drugs, the proportions of treated hypertensive patients achieving the recommended BP targets are persistently low, worldwide. Among the various factors that can be advocated for explaining the so-called “hypertension paradox”, low adherence to prescribed medications probably represents the most relevant. During the long-term treatment of hypertension, in fact, drug discontinuations due to therapeutic failure or occurrence of drug-related side effects and adverse reactions are very common.

This long-standing problem has been faced over time with multiple, often ineffective, strategies. In order to improve adherence to antihypertensive therapy and ameliorate BP control in the general population of hypertensive patients, in recent years a more extended use of combination therapies has been proposed. Such approach, based on the use of dual or triple combination therapies, especially in fixed formulations (single-pill approach), has demonstrated to provide effective and sustained BP control and ensure a higher rate of adherence than that obtained with different monotherapies.

In this chapter, we will discuss potential advantages of using fixed-dose combination therapeutic strategies. In particular, we will focus on the combinations that are supported by guidelines, such as therapies based on drug inhibiting the renin-angiotensin system and either thiazide diuretics or calcium-channel blockers or both, in order to improve BP control and achieve higher adherence to antihypertensive drug therapies. The improved adherence achieved with these combinations may substantially improve BP control and may contribute to substantially reduce the burden of cardiovascular and cerebrovascular diseases related to uncontrolled hypertension.

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Authors and Affiliations

  1. Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant’Andrea Hospital, Rome, Italy

    Massimo Volpe M.D., F.A.H.A., F.E.S.C., Giuliano Tocci M.D., Ph.D. & Giovanna Gallo M.D.

  2. IRCCS Neuromed, Pozzilli (IS), Italy

    Massimo Volpe M.D., F.A.H.A., F.E.S.C. & Giuliano Tocci M.D., Ph.D.

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  1. Massimo Volpe M.D., F.A.H.A., F.E.S.C.
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  2. Giuliano Tocci M.D., Ph.D.
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  3. Giovanna Gallo M.D.
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Correspondence to Massimo Volpe M.D., F.A.H.A., F.E.S.C. .

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  1. Service of Nephrology and Hypertension, CHUV, University of Lausanne, Lausanne, Vaud, Switzerland

    Michel Burnier

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Volpe, M., Tocci, G., Gallo, G. (2018). Use of Fixed-Dose Combinations in Hypertension and Cardiovascular Disease Prevention. In: Burnier, M. (eds) Drug Adherence in Hypertension and Cardiovascular Protection. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-76593-8_17

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