Abstract
Monotherapy is usually effective only in patiens with mild hypertension. Combination therapy is nowadays necessary for most (70-80%) patients with arterial hypertension.
The choice of appropriate combination depends on severity of hypertension, cardiovascular risk score and concomitant diseases. The combination of ACE-inhibitors and calcium channel blockers is the most potent combination with good effect on lowering of the cardiovascular risk.
The combination of three antihypertensive drugs should always comprise a thiazide diuretic. Exclusion of potential secondary cause is needed when hypertension is resistant to a combination of 3 antihypertensive drugs.
The use of fixed drug combinations allows decrese in the number of taken tablets, which could increase the compliance of patients and so increase the therapeutic effect.