Back to Browse Journals » Integrated Blood Pressure Control » Volume 4

A critical appraisal of the clinical effectiveness of a fixed combination of valsartan, amlodipine, and hydrochlorothiazide in achieving blood pressure goals

Authors Cheryl L Laffer, Fernando Elijovich

Published 19 January 2011 Volume 2011:4 Pages 1—5


Review by Single-blind

Peer reviewer comments 3

Cheryl L Laffer1, Fernando Elijovich2
1Section of Hypertension and Vascular Medicine, 2Division of General Internal Medicine, Department of Medicine, Texas A&M Health Sciences Center College of Medicine, Temple, TX USA

Abstract: Recent guidelines for the treatment of hypertension have focused on the need for multiple medications to get most patients to goal blood pressure (BP). Two to three different classes of antihypertensive agents are frequently required, increasing the risk of poor compliance with therapy. Hence, the guidelines have recommended starting with combination therapy in patients with BP that is over 20 mm Hg systolic or 10 mm Hg diastolic above goal. The latest advance in treatment regimen has been the development of triple-therapy combinations of an angiotensin receptor blocker, amlodipine, and hydrochlorothiazide. We review the pathophysiologic rationale for such a combination and the efficacy, safety, and tolerability of the first triple therapy that has become available: valsartan + amlodipine + hydrochlorothiazide. Finally, we suggest that use of triple therapy could improve the accuracy of diagnosing resistant hypertension, an increasingly prevalent and severe condition, by enhancing adherence to treatment and weeding out patients with pseudoresistance. This would allow for implementation of expensive and invasive workup only in those truly resistant patients in whom it is justified.

Keywords: combination therapy, compliance, hypertension control rates, resistant hypertension

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at:

Readers of this article also read:

Vitamin D status and hypertension: a review

Ke L, Mason RS, Kariuki M, Mpofu E, Brock KE

Integrated Blood Pressure Control 2015, 8:13-35

Published Date: 8 April 2015

Women’s perspectives on termination service delivery in Vietnam: a cross-sectional survey in three provinces

Ngo TD, Free C, Le HT, Edwards P, Pham KH, Nguyen YB, Nguyen TH

International Journal of Women's Health 2014, 6:927-933

Published Date: 30 October 2014

Development and characterization of magnetic iron oxide nanoparticles with a cisplatin-bearing polymer coating for targeted drug delivery

Unterweger H, Tietze R, Janko C, Zaloga J, Lyer S, Dürr S, Taccardi N, Goudouri OM, Hoppe A, Eberbeck D, Schubert DW, Boccaccini AR, Alexiou C

International Journal of Nanomedicine 2014, 9:3659-3676

Published Date: 5 August 2014

Recruited renin-containing renal microvascular cells demonstrate the calcium paradox regulatory phenotype

MacGriff S, Woo RE, Ortiz-Capisano MC, Atchison DK, Beierwaltes WH

Integrated Blood Pressure Control 2014, 7:9-17

Published Date: 13 January 2014

Current perspectives on rosuvastatin

Hu M, Tomlinson B

Integrated Blood Pressure Control 2013, 6:15-25

Published Date: 18 April 2013

Valsartan combination therapy in the management of hypertension – patient perspectives and clinical utility

David T Nash, Michael S McNamara

Integrated Blood Pressure Control 2009, 2:39-54

Published Date: 28 October 2009