Combination of antihypertensive drugs from a historical perspective

Optimizing combination therapy in the management of hypertension: the role of the aliskiren, amlodipine, and hydrochlorothiazide fixed combination

High blood pressure is the leading risk factor for death and disability worldwide, and the prevalence is increasing. Effective treatment decreases the risk of adverse events in proportion to blood pressure reduction. Combination antihypertensive therapy reduces blood pressure promptly and effectively. Single-pill combinations reduce the pill burden and improve adherence, efficacy, and tolerability of treatment compared with single drug pills. A significant portion of the hypertensive population will require three drugs for adequate control. The single-pill combination of aliskiren, amlodipine, and hydrochlorothiazide is based on complementary mechanisms of action. Clinical trials have shown it to be a safe and effective treatment for hypertension. This combination is a reasonable choice in clinical practice for patients with hypertension that requires three drugs for effective treatment.

Averting a pandemic health crisis in Europe by 2020: what physicians need to know regarding cholesterol management

BACKGROUND

Cardiovascular disease (CVD) represents a major cause of premature death, disability, and escalating healthcare costs throughout Europe. According to a recent report by the Stockholm Network (an independent European 'think tank'), major political, economic, social, and medical changes are urgently needed with respect to cholesterol management to help prevent CVD.

METHODS

To identify key cholesterol management issues that practitioners should consider to help prevent an impending European health crisis, our collective experience of policies and practices relating to CVD and cholesterol management in our respective countries was consolidated and used to develop this commentary.

RESULTS

Physicians and healthcare workers are uniquely positioned to make immediate and meaningful improvements in preventing and treating CVD if they recognize and address a handful of key clinical issues pertaining to cholesterol management. These issues include utilizing newer combination therapies and realizing the limitations of statins, improving compliance with cholesterol-lowering therapies, promoting a healthy lifestyle and diet, making treatment decisions based on patients' total CVD risk, fostering communication between primary and secondary providers, and soliciting governmental funding to implement disease management programmes.

CONCLUSIONS

By promptly and effectively addressing these cholesterol management issues, physicians and other healthcare professionals have an unprecedented opportunity to help reduce CVD in Europe to lessen the personal, social, and economic impact of this devastating disease.