Fixed combination has made a comeback as an initial therapy in the treatment of hypertension due to the fact that antihypertensive monotherapy does not address the multifactorial nature of hypertension as a disease with many pathways; using more than one drug makes more therapeutic sense, as combined agents cover more than one etiology. The additive or synergistic effect of combination therapy fully lowers blood pressure in patients who tend to have less than full response to one component only. Several different polypill formulations have been developed and trials demonstrated their short term feasibility, safety and efficacy. In addition, comparison of monthly out of pocket costs between fixed combinations and additive combinations indicate the advantage of effective combination therapy.
Importance of anti-diabetic and anti-lipidemic combinations should be emphasized as well: Many patients with diabetes mellitus may also be treated with dual pharmacological therapy as fixed combination: two or more drugs acting on different pathophysiological process is often necessary to reach early and sustained achievement of individualized glycemic targets. At the same time choosing the safest option to avoid hypoglycemia is of paramount importance compared with loose pill, both statin and anti-diabetic combination therapies may also have better adherence, improved satisfaction and lower drug costs.
The conference is intended for experts in the fields of diabetes, hypertension, dyslipidemia, internal medicine, cardiology, nephrology, endocrinology, family medicine, primary care physicians, nurse practitioners and physicians’ assistants. All are invited to explore the current and future role of fixed combinations in the treatment of hypertension, dyslipidemia and diabetes.