Combination Antihypertensive Agents

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Although all three of the broad categories of antihypertensive medications have been shown to reduce blood pressure, several possess physiological or metabolic side effects that are associated with increased risk for other pathological conditions. Already mentioned is the potassium-depleting characteristic of thiazide and loop diuretics, which results in an increased risk for arrhythmias and other metabolic disturbances. Similarly, beta-blockers have been shown to raise triglycerides and alter one's lipid profile (Kaplan, 2002). Because multiple antihy-pertensive agents may be needed to achieve optimal blood pressure control and to counteract some of the negative side effects associated with taking a single antihypertensive agent, many combination drugs have been made available. Demonstrating a synergy between agents, many of these combination agents have yielded better blood pressure control than single agents, often without producing negative side effects (Kaplan, 2002). As shown in Table 8.1, most of these pharmacologic agents involve the addition of a diuretic to other forms of antihy-pertensive medications.

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