Treatment algorithms for hypertension: a practical approach

Joel M Neutel

Renin–angiotensin system inhibitors, calcium channel blockers and diuretics

are the mainstay of current antihypertensive therapy. Patient characteristics are likely to

influence the individual response to these agents, although the majority of patients require

dual therapy to meet blood pressure goals and some require triple therapy. Combination

with complementary modes of action, and may reduce side-effect burden. Typically, patients

who require combination therapy will have comorbidities that influence the preferred

antihypertensive class for their treatment. Single-pill combinations can offer practical benefits,

but lack dose flexibility and may not comprise drug classes that are optimal for a specific patient.

The management of patients who require multiple therapies, therefore, involves weighing the

benefits of convenience against the need to select therapies based on a consideration of

therapeutic indications.

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Pratique clinique