ARB’s in combination therapy

Combination therapy is needed to achieve adequate control of blood pressure in most patients, especially those with systolic blood pressure ≥160 mmHg or diastolic ≥100 mmHg. Hypertension guidelines recommend the combination of at least two drugs with complementary mechanisms of action to achieve blood pressure control. In combination therapy, there are physiological and pharmacological synergies between different classes of agents, which cause a greater blood pressure reduction and fewer side-effects. Renin-angiotensin-aldosterone system blockade is a cornerstone of antihypertensive therapy. Many studies showed the effectivenes of angiotensin receptor blocker (ARB) in patients with hypertension, and they are among those most widely used in antihypertensive therapy. The combination of ARBs with either a diuretic or a calcium antagonist are among the preferred combinations. These combinations are well tolerated, effective, and causes blood pressure reductions and control rates than those that can be achieved with monotherapy. Olmesartan is an angiotensin II receptor antagonist which is widely examined in combination of either hydrochlorothiazide or amlodipine, showing improvements in antihypertensive efficacy with good tolerability. The aim of this review was to evaluate the combination of ARBs with diuretic and calcium channel blockers.