Abstract
The standard of treatment in patients with systemic arterial hypertension has a profound effect on the incidence of cardiovascular morbidity and mortality. The aim of an effective pharmacological treatment, aside from meeting BP targets, is to meet clinical endpoints, i.e. to reduce the incidence levels of cardiovascular events.
In order to achieve this goal, it is essential to apply a combination therapy in a majority of patients using medication with complementary mechanisms, together with a clinical proof of cardiovascular protection. Fixed combinations favour adherence to drug therapy.
The combination of angiotensin converting enzyme (ACE) inhibitors and calcium antagonists can be recommended as a basic alternative to a combination of two drugs. For two decades, ramipril and amlodipine have belonged to a group of established ACE inhibitors and calcium antagonists with the evidence for reducing cardiovascular events.
Their combination supports the evidence for complementary pharmacodynamic effects and higher tolerability as a consequence of low incidence of adverse events compared to a single drug therapy. The recently released combination of ramipril plus amlodipin represents an example of an optimal medical treatment of arterial hypertension.
The dosage of a fixed combination of ramipril/amlodipin varies individually and universal recommendations for an exact dosage are not available. The dosage scheme presented in this article is based upon clinical practice.
In case of a suboptimal effect of a fixed combination, the strategy for a combination treatment augmentation is available.