By Joel M. Neutel
For over 30 years, the stepped care process has been utilized in the administration and therapy of high blood pressure. This strategy advocates using preliminary monotherapy to arrive the specified blood strain, and the following use of extra medications with complementary modes of motion, till the objective BP is completed. notwithstanding, present keep an eye on charges for high blood pressure recommend that such an strategy should be superseded and not powerful within the administration of high blood pressure. medical trials have proven that greater than 50% of sufferers require a mix of drug remedies to accomplish their goal BP. a few proponents of mixture remedy have argued that the danger of inauspicious uncomfortable side effects and non-compliance could be less than that in comparison to monotherapy, which at the beginning calls for larger doses to be administered to be powerful. for this reason, there were expanding calls of the need for a way more mixed method within the therapy of high blood pressure. including to this, blend treatment in high blood pressure will hide present keep watch over charges of blood strain around the globe, the advantages of monotherapy and blend remedy, research the effectiveness, hazard of inauspicious results, compliance, and value of the on hand treatments and also will comprise info on proper end result studies.
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Example text
Of these responding patients, around 60–70% will require the highest recommended dose of monotherapy to achieve blood pressure control. Most of the adverse events associated with antihypertensive treatment are dose dependent (except for angiotensin-converting enzyme [ACE] inhibitorinduced cough), which means that patients who are receiving high doses of monotherapy are more likely to experience drug-related side effects than patients treated and controlled on low-dose combination therapy. The lower risk of adverse effects with low-dose combination therapy supports the increased interest in a more combined approach to the treatment of hypertension.
Nephrol T 200 21 1 9 7 2 F H B BS C LR A assess combination therapy in hypertension. Treatment with bisoprolol and hydrochlorothiazide. Arch Intern Med 1994; 154:1461–8. 3. Kochar M, Guthrie R, Triscari J, Kassler-Taub K, Reeves RA. Matrix study of irbesartan with hydrochlorothiazide in mild-to-moderate hypertension. Am J Hypertens 1999; 12:797–805. C S MA AC H E with the combination of olmesartan medoxomil and hydrochlorothiazide. Am J Hypertens 2004; 17:252–9. 5. Neutel JM. The use of combination drug therapy in the treatment of hypertension.
Reproduced with permission from Neutel JM. The role of combination therapy in the management of hypertension. N T 200 21 1 9 7 According to surveys of physicians, the efficacy and safety of antihypertensive drugs are the most important qualities to consider when selecting initial drugs for treatment of hypertension [1]. e. efficacy and safety are opposed. e. 7). It has been suggested that a disadvantage of combination therapy, compared with monotherapy, is that it in the presence of an adverse event it is more difficult to identify the drug that is causing the problem.
