Skip to main content
SpringerLink
Log in

Use of Combination Therapy in Special Populations

  • Chapter
  • First Online:
Combination Therapy in Hypertension

  • 591 Accesses

Abstract

Many different physiological factors contribute to the development of hypertension. The relative contribution of these factors varies between different population subgroups. As a result, the responsiveness of the subgroups to antihypertensive medications also varies. However, the results of clinical studies indicate that administration of low-dose combination therapy enables adequate blood pressure control to be achieved in all subgroups of hypertensive patients, including the elderly, African–Americans, Caucasians, and patients with diabetes or metabolic syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 49.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Nash DT. Systolic hypertension. Geriatrics 2006; 61(12):22–8.

    Google Scholar 

  2. Sadowski AV, Redeker NS. The hypertensive elder: a review for the primary care provider. Nurse Pract 1996; 21(5):99–102, 105–12, 118.

    Google Scholar 

  3. Papademetriou V. Hypertension and cognitive function. Blood pressure regulation and cognitive function: a review of the literature. Geriatrics 2005; 60(1):20–2, 24.

    Google Scholar 

  4. Neutel JM, Weber MA, Julius S, et al. Clinical experience with perindopril in elderly hypertensive patients: a subgroup analysis of a large community trial. Am J Cardiovasc Drugs 2004; 4(5):335–41.

    Google Scholar 

  5. Chalmers J, Castaigne A, Morgan T, Chastang C. Long-term efficacy of a new, fixed, verylow-dose angiotensin-converting enzyme-inhibitor/diuretic combination as first-line therapy in elderly hypertensive patients. J Hypertens 2000; 18(3):327–37.

    Google Scholar 

  6. Ferdinand KC, Saunders E. Hypertension-related morbidity and mortality in African Americans – why we need to do better. J Clin Hypertens 2006; 8(1 Suppl 1):21–30.

    Google Scholar 

  7. Saunders E. Managing hypertension in African-American patients. J Clin Hypertens 2004; 6(4 Suppl 1):19–25.

    Google Scholar 

  8. Ferdinand KC, Armani AM. The management of hypertension in African Americans. Crit Pathol Cardiol 2007; 6(2):67–71.

    Google Scholar 

  9. Wright JT Jr, Douglas J. Optimal treatment of hypertension and cardiovascular risk reduction in African Americans: treatment approaches for outpatients. J Clin Hypertens 2003; 5(1 Suppl 1):18–25.

    Google Scholar 

  10. Saunders E. Tailoring treatment to minority patients. Am J Med 1990; 88(3B):21–23S.

    Google Scholar 

  11. Lackland DT, Lin Y, Tilley BC, Egan BM. An assessment of racial differences in clinical practices for hypertension at primary care sites for medically underserved patients. J Clin Hypertens 2004; 6(1):26–31; quiz 32–3.

    Google Scholar 

  12. McGill JB, Reilly PA. Combination treatment with telmisartan and hydrochlorothiazide in black patients with mild to moderate hypertension. Clin Cardiol 2001; 24(1):66–72.

    Google Scholar 

  13. Bakris GL, Smith DH, Giles TD, White WB, Davidai G, Weber MA. Comparative antihypertensive efficacy of angiotensin receptor blocker-based treatment in African-American and white patients. J Clin Hypertens 2005; 7(10):587–95; quiz 596–7.

    Google Scholar 

  14. Douglas JG, Bakris GL, Epstein M, et al. Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Management of high blood pressure in African Americans: consensus statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks. Arch Intern Med 2003; 163(5):525–41.

    Google Scholar 

  15. Sowers JR. Recommendations for special populations: diabetes mellitus and the metabolic syndrome. Am J Hypertens 2003; 16(11 Pt 2):41S–45S.

    Google Scholar 

  16. Mancia G. The association of hypertension and diabetes: prevalence, cardiovascular risk and protection by blood pressure reduction. Acta Diabetol 2005; 42(Suppl 1):S17–25.

    Google Scholar 

  17. Ferdinand KC. Management of cardiovascular risk in patients with type 2 diabetes mellitus as a component of the cardiometabolic syndrome. J Cardiometab Syndr 2006; 1(2):133–40.

    Google Scholar 

  18. Giunti S, Cooper M. Management strategies for patients with hypertension and diabetes: why combination therapy is critical. J Clin Hypertens 2006; 8(2):108–13.

    Google Scholar 

  19. Tatti P, Pahor M, Byington RP, et al. Outcome results of the fosinopril versus amlodipine cardiovascular events randomized trial (FACET) in patients with hypertension and NI DDM. Diabetes Care 1998; 21:597–603.

    Google Scholar 

  20. Bakris GL, Weir MR, DeQuattro V, McMahon FG. Effects of an ACE inhibitor/calcium antagonist combination on proteinuria in diabetic nephropathy. Kidney Int 1998; 54:1283–9.

    Google Scholar 

  21. Ogawa S, Takeuchi K, Mori T, Nako K, Tsubono Y, Ito S. Effects of monotherapy of temocapril or candesartan with dose increments or combination therapy with both drugs on the suppression of diabetic nephropathy. Hypertens Res 2007; 30(4):325–34.

    Google Scholar 

  22. Fogari R, Derosa G, Zoppi A, et al. Effects of manidipine/delapril versus olmesartan/hydrochlorothiazide combination therapy in elderly hypertensive patients with type 2 diabetes mellitus. Hypertens Res 2008; 31:43–50.

    Google Scholar 

  23. Sharma AM, Davidson J, Koval S, Lacourcière Y. Telmisartan/hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese hypertensive patients with type 2 diabetes: the SMOOTH study. Cardiovasc Diabetol 2007; 6:28.

    Google Scholar 

  24. Fox JC, Leight K, Sutradhar SC, et al. The JNC 7 approach compared to conventional treatment in diabetic patients with hypertension: a double-blind trial of initial monotherapy vs. combination therapy. J Clin Hypertens (Greenwich). 2004; 6(8):437–42; quiz 443–4.

    Google Scholar 

  25. Agrawal R, Marx A, Haller H. Efficacy and safety of lercanidipine versus hydrochlorothiazide as add-on to enalapril in diabetic populations with uncontrolled hypertension. J Hypertens 2006; 24(1):185–92.

    Google Scholar 

  26. Fernández R, Puig JG, Rodríguez-Pérez JC, Garrido J, Redon J; TRA VEN D Study Group. Effect of two antihypertensive combinations on metabolic control in type-2 diabetic hypertensive patients with albuminuria: a randomised, double-blind study. J Hum Hypertens 2001; 15:849–56.

    Google Scholar 

  27. Krum H, Skiba M, Gilbert RE. Comparative metabolic effects of hydrochlorothiazide and indapamide in hypertensive diabetic patients receiving ACE inhibitor therapy. Diabet Med 2003;20:708–12.

    Google Scholar 

  28. Mitrakou A. Women’s health and the metabolic syndrome. Ann NY Acad Sci 2006; 1092:33–48.

    Google Scholar 

  29. Darsow T, Kendall D, Maggs D. Is the metabolic syndrome a real clinical entity and should it receive drug treatment? Curr Diab Rep 2006; 6(5):357–64.

    Google Scholar 

  30. Deedwania PC, Gupta R. Management issues in the metabolic syndrome. J Assoc Physicians India 2006; 54:797–810.

    Google Scholar 

  31. Ganne S, Arora S, Karam J, McFarlane SI. Therapeutic interventions for hypertension in metabolic syndrome: a comprehensive approach. Expert Rev Cardiovasc Ther 2007; 5(2):201–11.

    Google Scholar 

  32. Bakris G, Molitch M, Hewkin A, et al., STAR Investigators. Differences in glucose tolerance between fixed-dose antihypertensive drug combinations in people with metabolic syndrome. Diabetes Care 2006; 29(12):2592–7.

    Google Scholar 

  33. Nash DT. Rationale for combination therapy in hypertension management: focus on angiotensin receptor blockers and thiazide diuretics. South Med J 2007; 100(4):386–92.

    Google Scholar 

  34. Kintscher U, Bramlage P, Paar WD, Thoenes M, Unger T. Irbesartan for the treatment of hypertension in patients with the metabolic syndrome: a sub analysis of the Treat to Target post authorization survey. Prospective observational, two armed study in 14,200 patients. Cardiovasc Diabetol 2007; 6:12.

    Google Scholar 

  35. Morisco C, Lembo G, Sarno D, et al. Benefits of combination therapy in hypertensive patients with associated coronary artery disease: a subgroup with specific demands. J Cardiovasc Pharmacol 1998; 31(Suppl 2):S27–33.

    Google Scholar 

  36. Docherty A, Dunn FG. Treatment of hypertensive patients with coexisting coronary arterial disease. Curr Opin Cardiol 2003; 18(4):268–71.

    Google Scholar 

  37. Elliott WJ, Hewkin AC, Kupfer S, Cooper-DeHoff R, Pepine CJ. A drug dose model for predicting clinical outcomes in hypertensive coronary disease patients. J Clin Hypertens 2005; 7(11):654–63.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Internal Medicine, Orange County Research Center, Tustin, CA, USA

    Joel Neutel

Authors
  1. Joel Neutel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joel Neutel .

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Healthcare

About this chapter

Cite this chapter

Neutel, J. (2011). Use of Combination Therapy in Special Populations. In: Combination Therapy in Hypertension. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-908517-28-9_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-908517-28-9_4

  • Published:

  • Publisher Name: Springer Healthcare, Tarporley

  • Print ISBN: 978-1-908517-25-8

  • Online ISBN: 978-1-908517-28-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation