Combination therapy in hypertension

Arterial hypertension is the most important modifiable cardiovascular risk factor leading to death in general population. Optimal treatment strategies are continuously being debated and both the initiation and maintenance of a pharmacologic approach have been evaluated in the latest clinical trials. Although monotherapy is widely used as the initial therapy in most of the hypertensives, blood pressure-lowering drug combinations have offered some benefits in high-cardiovascular risk patients. It is part of common clinical experience that the vast majority of patients with stage 2 hypertension require 2 or more pharmacologic agents to obtain a satisfying control. Moreover, antihypertensive combinations should be considered in a number of clinical situations depending on the cardio-renal risk.