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Symposia & Webinars

Use of triple combinations in hypertension management: from guidelines to clinical practice

 

Professor Giuseppe Mancia’s presentation reviews the latest evidence and recommendations about lowering blood pressure (BP). Considering that monotherapy provides BP control only for a limited number of hypertensive patients, the need for a combination treatment emerges. According to European guidelines and clinical studies:

  • Combination therapy begins later than it should according to guidelines recommendations.
  • Stepped care therapy needs at least 2 drugs for BP control, but it presents a non-homogeneous level of adherence.
  • Single pill (double) combination therapy provides higher adherence and BP control than monotherapy, and a lower CV risk.
  • Therapeutic efficacy and adherence further increase with triple combination therapy.

The actual drug treatment recommendation includes 3 steps:

  1. Dual drug combination (ACE inhibitors (ACEi) or Angiotensin 2 receptors blockers (ARB) + Calcium channel blockers (CCB) or thiazide or thiazide like).
  2. Triple combination (ACEi or ARB + CCB + thiazide or thiazide like).
  3. Triple combination + other drugs (diuretics).

Despite the benefits and the guidelines recommendations, there is still a lack in clinical practice for combination treatment use.

This video is part of the session “Triple single-pill combination in the management of hypertension: earlier and broader use?” held virtually at ESC Congress 2020 on Sunday August 30th, 2020, with chairperson Costas Tsioufis (Greece).

View also the other parts of the congress session: