Effective blood pressure-lowering therapy: what to consider?

M.D. Smirnova¹, D.V. Nebieridze²

¹National Medical Research Center of Cardiology, Moscow

²National Medical Research Center of Therapy and Preventive Medicine, Moscow

Treatment for arterial hypertension (AH) implies a reduction of blood pressure and organ protection since organ involvement (e.g., left ventricular hypertrophy, microalbuminuria, etc.) significantly increases the risk of cardiovascular events. Damage of target organs is relatively common in AH, even at early stages. Numerous randomized clinical trials have demonstrated that monotherapy effectively reduces BP only in a few patients, while most patients require a combination of at least two medications to control BP. This review paper discusses the selection of optimal hypotensive drug combinations. Clinical trials demonstrate the advantages of combining an angiotensin-converting enzyme inhibitor (ramipril) and calcium channel blocker (amlodipine), particularly a fixed-dose combinati on of ramipril and amlodipine, in routine practice in various patient groups. This combination provides pleiotropic effects. The role of depression and anxiety as significant independent risk factors of cardiovascular events is discussed. The importance of smoking cessation, body weight control, and physical activity is highlighted.

Keywords: ramipril, amlodipine, fixed-dose combination, blood pressure-lowering treatment, organ protection.

For citation: Smirnova M.D., Nebieridze D.V. Effective blood pressure-lowering therapy: what to consider? RMJ. 2021;9:22–26.