, Volume 69, Issue 13, pp 1761–1776 | Cite as

Fixed-Dose Combinations as Initial Therapy for Hypertension

A Review of Approved Agents and a Guide to Patient Selection
  • Bernard Waeber
  • François Feihl
  • Luis M. Ruilope
Review Article


Recent guidelines recommend initiation of antihypertensive therapy with fixed-dose combinations in high-risk patients because such patients usually need two or more blood pressure (BP)-lowering agents in order to normalize their BP. Agents that block the renin-angiotensin system (ACE inhibitors or angiotensin II receptor antagonists [angiotensin receptor blockers; ARBs]) are preferred for the management of hypertension in most patients exhibiting subclinical target organ damage, or established cardiovascular or renal diseases. Unless contraindicated they should be one of the components of fixed-dose combinations, whereas the other component may be either a calcium channel antagonist or a thiazide diuretic. Fixed-dose combinations containing an ACE inhibitor or ARB plus a calcium channel antagonist appear particularly effective in preventing complications of coronary heart disease.


Amlodipine Valsartan Perindopril HCTZ Calcium Channel Antagonist 



No sources of funding were used to assist in the preparation of this review and the authors declare that they are alone responsible for the content. Dr Waeber has received honoraria from Novartis, Servier, Abbott, Sanofi-aventis, AstraZeneca, Daiichi Sankyo and Menarini. Dr Ruilope received honoraria from Novartis, Bayer, Sanofi-aventis, Bristol-Myers Squibb, GlaxoSmithKline, Merck, Servier, Menarini, AstraZeneca, Takeda and Daiichi-Sankyo, and research grants from Novartis, Bayer, Sanofi-aventis and Daiichi-Sankyo. Dr Feihl has no conflicts of interest that are directly relevant to the content of this review.


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Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Bernard Waeber
    • 1
  • François Feihl
    • 1
  • Luis M. Ruilope
    • 2
  1. 1.Division of Clinical PathophysiologyCentre Hospitalier Universitaire Vaudois et Université de LausanneLausanneSwitzerland
  2. 2.Hypertension UnitHospital 12 de OctubreMadridSpain

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