Role of valsartan, amlodipine and hydrochlorothiazide fixed combination in blood pressure control: an update

Review

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Authors: Maurizio Destro, Francesca Cagnoni, Antonio D’Ospina, et al

Published Date April 2010 Volume 2010:6 Pages 253 - 260

DOI: http://dx.doi.org/10.2147/VHRM.S6805

Maurizio Destro¹, Francesca Cagnoni¹, Antonio D’Ospina¹, Alessandra Rossi Ricci¹, Elena Demichele¹, Emmanouil Peros¹, Augusto Zaninelli², Paola Preti³

¹Internal Medicine, Ospedale Unificato Broni-Stradella, Stradella (PV), Italy; ²General Medicine, School of Medicine, University of Florence, Florence, Italy; ³Internal Medicine, University of Pavia, Pavia, Italy

Abstract: The treatment of moderate or severe hypertension in most cases requires the contemporaneous use of multiple antihypertensive agents. The most available two-drug combinations have an agent that addresses renin secretion and another one that is statistically more effective in renin-independent hypertension. The practice of combining agents that counteract different mechanisms is the most likely explanation for the fact that most available two-drug combinations have an agent that addresses renin secretion (beta-blocker, angiotensin converting enzyme inhibitor, angiotensin II receptor blocker or direct renin inhibitor) and another one that is more effective in renin-independent hypertension (diuretic, dihydropyridine or non-dihydropyridine calcium channel blocker). Based on these considerations, addition of hydrochlorothiazide to the combination of an antagonist of the renin-angiotensin system with a calcium channel blocker would constitute a logical approach. Inclusion of a diuretic in the triple combination is based on the evidence that these agents are effective and cheap, enhance the effect of other antihypertensive agents, and add a specific effect to individuals with salt-sensitivity of blood pressure. The benefit of triple combination therapy with amlodipine, valsartan and hydrochlorothiazide over its dual component therapies has been demonstrated, and the use of a single pill will simplify therapy resulting in better blood pressure control.

Keywords: valsartan, amlodipine, hydrochlorothiazide, HCTZ, blood pressure, hypertension

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