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Treatment and management of Hypertension using Combinatorial therapy: A recent Approach

Pratik Kumar Vishwakarma, Meera Kumari, Amresh Gupta

Abstract


One of the most frequent and widespread illnesses is hypertension. Nowadays, several medications are used to treat hypertension but are implicated in having some severe side effects. So, to overcome these side effects, there is the usage of a combination of drugs based on lesser side effects and an increase in efficacy or therapeutic goals. Although the first pharmacological therapy impacts long-term results, lowering blood pressure is the most critical factor in reducing CV risk. According to available statistics, to fulfill current BP goals, at least 75% of patients will require a mix of treatments. Clinical practice is increasingly focusing on the practical aspects of achieving and maintaining target blood pressure regularly. To reach treatment goals, the majority of hypertension patients will need a combo of antihypertensive drugs; current recommendations suggest beginning systolic blood pressure >20 mmHg and diastolic blood pressure >10 mmHg over the objectives, as well as those with a high stroke disease, should receive medical care with two drugs. In this review article, we analyze the recent data that is available to treat hypertension in the combination form of drugs


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References


S. Oparil et al., “Hypertension,” Nat. Rev. Dis. Prim., vol. 4, Mar. 2018, doi: 10.1038/NRDP.2018.14.

V. L. Burt et al., “Trends in the prevalence, awareness, treatment, and control of hypertension in the

adult US population. Data from the health examination surveys, 1960 to 1991,” Hypertens. (Dallas, Tex.

, vol. 26, no. 1, pp. 60–69, 1995, DOI: 10.1161/01.HYP.26.1.60.

R. A. Sanchez et al., “Latin American guidelines on hypertension,” J. Hypertens., vol. 27, no. 5, pp.

–922, 2009, doi: 10.1097/HJH.0b013e32832aa6d2.

R. V. Oliva and G. L. Bakris, “Management of hypertension in the elderly population,” J. Gerontol. A.

Biol. Sci. Med. Sci., vol. 67, no. 12, pp. 1343–1351, Dec. 2012, doi: 10.1093/GERONA/GLS148.

J. Stamler, “Blood pressure and high blood pressure. Aspects of risk,” Hypertens. (Dallas, Tex. 1979),

vol. 18, no. 3 Suppl, pp. I-95-I–107, 1991, doi: 10.1161/01.HYP.18.3_SUPPL.I95.

E. Pimenta and S. Oparil, “Fixed combinations in the management of hypertension: patient perspectives

and rationale for development and utility of the olmesartan-amlodipine combination,” Vasc. Health Risk

Manag., vol. 4, no. 3, pp. 653–664, 2008, doi: 10.2147/VHRM.S2586.

D. P. De Lima, “Synthesis of angiotensin-converting enzyme (ACE) inhibitors: an important class of

antihypertensive drugs,” undefined, vol. 22, no. 3, pp. 375–381, May 1999, doi: 10.1590/S0100-

M. Y. Abeywardena, L. T. Jablonskis, and R. J. Head, “Age- and hypertension-induced changes in

abnormal contractions in rat aorta,” J. Cardiovasc. Pharmacol., vol. 40, no. 6, pp. 930–937, Dec. 2002,

doi: 10.1097/00005344-200212000-00015.

İ. Üniversitesi, F.-E. Fakültesi, B. Bölümü, / Malatya, Z. Selamoğlu, and M. Yürekli, “The Effects of

Enalapril Maleate and Cold Stress on Some Blood Parameters,” vol. 1, pp. 6–12, 2005.

D. W. Cushman, H. S. Cheung, E. F. Sabo, and A. Ondetti, “Design of Potent Competitive Inhibitors of

Angiotensin-Converting Enzyme. Carboxyalkanoyl and Mercaptoalkanoyl Amino Acids,”

Biochemistry, vol. 16, no. 25, pp. 5484–5491, Dec. 1977, doi:

1021/BI00644A014/SUPPL_FILE/BI00644A014_SI_001.PDF.

H. G. Byun and S. K. Kim, “Structure and activity of angiotensin I converting enzyme inhibitory

peptides derived from alaskan pollack skin,” J. Biochem. Mol. Biol., vol. 35, no. 2, pp. 239–243, 2002,

doi: 10.5483/BMBREP.2002.35.2.239.

B. S. Harris, K. C. Bishop, H. R. Kemeny, J. S. Walker, E. Rhee, and J. A. Kuller, “Risk factors for

birth defects,” Obstet. Gynecol. Surv., vol. 72, no. 2, pp. 123–135, 2017, doi:

1097/OGX.0000000000000405.

T. Hayek et al., “The angiotensin-converting enzyme inhibitor, fosinopril, and the angiotensin II

receptor antagonist, losartan, inhibit LDL oxidation and attenuate atherosclerosis independent of

lowering blood pressure in apolipoprotein E deficient mice,” Cardiovasc. Res., vol. 44, no. 3, pp.

–587, Dec. 1999, doi: 10.1016/S0008-6363(99)00239-4/2/44-3-579-FIG6.GIF.

K. Arihara, Y. Nakashima, T. Mukai, S. Ishikawa, and M. Itoh, “Peptide inhibitors for angiotensin I-

converting enzyme from enzymatic hydrolysates of porcine skeletal muscle proteins,” Meat Sci., vol.

, no. 3, pp. 319–324, 2001, doi: 10.1016/S0309-1740(00)00108-X.

J. Odović, B. Stojimirović, M. Aleksić, D. Milojković-Opsenica, and Ž. Tešiś, “Reversed-phase thin-

layer chromatography of some angiotensin converting enzyme (ACE) inhibitors and their active

metabolites,” J. Serbian Chem. Soc., vol. 71, no. 6, pp. 621–628, 2006, doi: 10.2298/JSC0606621O.

M. Volpe, G. Gallo, and G. Tocci, “Is early and fast blood pressure control important in hypertension

management?,” Int. J. Cardiol., vol. 254, pp. 328–332, Mar. 2018, doi: 10.1016/J.IJCARD.2017.12.026.

M. Burnier, “Antihypertensive Combination Treatment: State of the Art,” Curr. Hypertens. Rep., vol.

, no. 7, Jul. 2015, doi: 10.1007/S11906-015-0562-0.

D. S. Wald, M. Law, J. K. Morris, J. P. Bestwick, and N. J. Wald, “Combination therapy versus

monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials,” Am. J.

Med., vol. 122, no. 3, pp. 290–300, Mar. 2009, doi: 10.1016/J.AMJMED.2008.09.038.

A. F. Rubio-Guerra, D. Castro-Serna, C. I. Elizalde Barrera, and L. M. Ramos-Brizuela, “Current

concepts in combination therapy for the treatment of hypertension: combined calcium channel blockers

and RAAS inhibitors,” Integr. Blood Press. Control, vol. 2, pp. 55–62, 2009, doi: 10.2147/IBPC.S6232.

A. V. Chobanian et al., “Seventh Report of the Joint National Committee on Prevention, Detection,

Evaluation, and Treatment of High Blood Pressure,” Hypertension, vol. 42, no. 6, pp. 1206–1252, Dec.

, doi: 10.1161/01.HYP.0000107251.49515.C2.

G. L. Bakris, “Combined therapy with a calcium channel blocker and an angiotensin II type 1 receptor

blocker,” J. Clin. Hypertens. (Greenwich)., vol. 10, no. 1 Suppl 1, pp. 27–32, Jan. 2008, doi:

1111/J.1524-6175.2007.08029.X.

D. Poldermans et al., “Tolerability and blood pressure-lowering efficacy of the combination of

amlodipine plus valsartan compared with lisinopril plus hydrochlorothiazide in adult patients with stage

hypertension,” Clin. Ther., vol. 29, no. 2, pp. 279–289, Feb. 2007, doi:

1016/j.clinthera.2007.02.003.

S. G. Chrysant, T. Fagan, R. Glazer, and A. Kriegman, “Effects of benazepril and hydrochlorothiazide,

given alone and in low- and high-dose combinations, on blood pressure in patients with hypertension,”

Arch. Fam. Med., vol. 5, no. 1, pp. 17–24, 1996, doi: 10.1001/ARCHFAMI.5.1.17.

E. Ambrosioni, C. Borghi, and F. Costa, “Captopril and hydrochlorothiazide: rationale for their

combination,” Br. J. Clin. Pharmacol., vol. 23 Suppl 1, no. Suppl 1, pp. 43S-50S, 1987, doi:

1111/J.1365-2125.1987.TB03121.X.

W. H. Frishman et al., “Comparison of amlodipine and benazepril monotherapy to amlodipine plus

benazepril in patients with systemic hypertension: a randomized, double-blind, placebo-controlled,

parallel-group study. The Benazepril/Amlodipine Study Group,” J. Clin. Pharmacol., vol. 35, no. 11,

pp. 1060–1066, 1995, doi: 10.1002/J.1552-4604.1995.TB04027.X.

A. H. Gradman, N. R. Cutler, P. J. Davis, J. A. Robbins, R. J. Weiss, and B. C. Wood, “Combined

enalapril and felodipine extended release (ER) for systemic hypertension. Enalapril-Felodipine ER

Factorial Study Group,” Am. J. Cardiol., vol. 79, no. 4, pp. 431–435, Feb. 1997, doi: 10.1016/S0002-

(96)00781-3.

B. Dahlöf et al., “Felodipine-metoprolol combination tablet: maintained health-related quality of life in

the presence of substantial blood pressure reduction,” Am. J. Hypertens., vol. 18, no. 10, pp. 1313–1319,

Oct. 2005, doi: 10.1016/J.AMJHYPER.2005.04.017.

W. H. Frishman, J. W. Hainer, and J. Sugg, “A factorial study of combination hypertension treatment

with metoprolol succinate extended release and felodipine extended release results of the Metoprolol

Succinate-Felodipine Antihypertension Combination Trial (M-FACT),” Am. J. Hypertens., vol. 19, no.

, pp. 388–395, Apr. 2006, doi: 10.1016/J.AMJHYPER.2005.10.007.

S. Oparil, S. A. Yarows, S. Patel, H. Fang, J. Zhang, and A. Satlin, “Efficacy and safety of combined

use of aliskiren and valsartan in patients with hypertension: a randomised, double-blind trial,” Lancet

(London, England), vol. 370, no. 9583, pp. 221–229, Jul. 2007, doi: 10.1016/S0140-6736(07)61124-6.


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