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The combination therapy in hypertension - organ damage

If conditionally present by hypertension organ damage such as an enlargement of the left ventricle, changes of the retinal arteries, kidney damage and changes in the artery by arteriosclerosis (atherosclerosis), this gives forcibly consequences in the combination therapy of hypertension.

It is first of all to deal with this type of organ damage before the doctor or therapist by diagnosing a therapy for / the affected person (s) can create.

- In the brain, it can cause a mini stroke (TIA), however, the leaves no lasting damage to the brain and can be brought in connection with hypertension.

- In the eyes can cause fluid retention, bleeding of the retina which is also associated with hypertension. Typical are changes in retinal arteries.

- The most famous episode and probably the most feared organ damage is the heart attack. The impact force of the left ventricle (left ventricular failure) is no longer sufficient, leading to infarction, but also the angina pectoris (chest tightness) is caused by hypertension.




Often helps only the combination therapy

Hypertension does not have to - combination therapy
Combination therapy in hypertension

- The kidneys can be damaged as a result of high blood pressure and loss of protein through the urine can be a result of organ damage. Most elevated creatinine is detected and several functional limitations are often the result.

Through hypertension-related organ damage are treated with a special combination therapy in conjunction with a high blood pressure therapy. Work is carried out mainly with two drugs at low doses that are known as so-called combination preparation.

Only when this form of therapy is not successful, the dosage is increased and further poor results switched to a combination product consisting of a triple combination (ACE inhibitors, diuretics and calcium channel blocker).

The efficacy of combination therapy has been shown, among other things, 2007 at the Congress of the European Community for hypertension in Milan.

According to the studies presented here therapy has the latest on the second active ingredient a reduction of According hypertension while on treatment with one drug only about 20% of patients achieved a decrease in blood pressure at about 75% of those affected.

Treatment with the triple preparation then has successfully taken in 90% of hypertensive patients.




Combination therapy - which combinations

The following is a list of combination preparations which are used to ensure a reduction of high blood pressure:

ACE inhibitor plus diuretic
Ramipril + Piretamid, perindopril + indapamide. Furthermore, captopril, benazepril, enalapril, lisinopril, ramipril, cilazapril, fosinopril, moexipril Quinapil and can be combined with hydrochlorothiazide.

ACE inhibitor plus calcium channel blockers
Lercanidipine and enalapril, ramipril and felodipine in combination with and Trandoapril Verapilm.

Beta-blocker plus diuretic
In combination with chlorthalidone Atenolol +, + piretanide Penbutolol, furosemide + Penbutolol, hydrochlorothiazide + bisoprolol, metoprolol + chlorthalidone, hydrochlorothiazide and chlorthalidone oxprenolol + + metoprolol.

Beta blockers plus calcium channel blockers
As a combination of nifedipine + metoprolol, atenolol and metoprolol Nifedepin with with felodipine.

Calcium channel blockers plus AT1 receptor antagonist
For example, amlodipine with valsartan.

Diuretic plus AT1 receptor antagonist
In combination of valsartan with hydrochlorothiazide or a combination of candesartan, telmisartan, losartan and irbesartan with hydrochlorothiazide.

Diuretic plus AT2 receptor antagonist
In the combination of eprosartan with hydrochlorothiazide.

Diuretic plus antihypertensives which act specifically on the nervous system
For example clopamide and reserpine or mefruside reserpine.

2 diuretics plus calcium channel blockers
As a combination of hydrochlorothiazide with triamterene and verapamil HCl.



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