Med. praxi 2012; 9(8-9): 319-324

Combination treatment for hypertension in the year 2012

prof.MUDr.Jindřich Špinar, CSc., FESC¹, prof.MUDr.Jiří Vítovec, CSc.²

¹ Interní kardiologická klinika FN Brno a LF MU, Brno

² I. interní kardioangiologická klinika FN u sv. Anny a LF MU, Brno

In the year 2007, new European guidelines on the diagnosis and treatment of hypertension were issued, followed by both Czech and

British guidelines in 2008 and by the Reappraisal of European Guidelines in 2009. In 2011, new NICE (British) guidelines were released

and new Czech Society of Hypertension guidelines are prepared in 2012. The individual guidelines are very similar, still some differences

exist. The Czech Society of Hypertension has adopted the European classification with three prehypertension grades (optimal, normal,

and high-normal blood pressure), three grades of hypertension, and isolated systolic hypertension as an independent entity. The management

of hypertension mainly consists in achievement of normotension and use of combination treatment according to comorbid

conditions. Good control of systolic blood pressure as well as control for additional risk parameters is essential.

The most commonly recommended double combinations include a renin-angiotensin-aldosterone system (RAAS) blocker – an ACEI or

a sartan plus a calcium blocker, followed by a renin-angiotensin-aldosterone system blocker plus a diuretic, and a calcium blocker plus

a diuretic. Recently, a fixed combination of a calcium blocker plus a beta blocker has emerged. Recommended diuretics include primarily

indapamide, secondly chlorthalidone; by contrast, hydrochlorothiazide is viewed critically.

The main advantage of fixed combinations is increased patient compliance and, thus, better control of hypertension. We present

an overview of fixed combinations of RAAS blockers plus calcium blockers registered in the Czech Republic as of May 2012.

Keywords: hypertension, guidelines, combination treatment, fixed combination

Published: September 25, 2012  Show citation