Combination antihypertensive therapy, particularly fixed-dose combinations of diuretics and ACE inhibitors or ARBs, is often necessary and effective for improving blood pressure control in the elderly.
May support fixed-dose combinations in elderly hypertension; leaves open need for dedicated RCTs before practice change.
Hypertension control rates in the elderly, particularly for systolic hypertension, are poor and lower than control rates in other age groups. Older patients often require treatment with specific antihypertensive drugs because of concomitant conditions and usually need > or =2 drugs to control blood pressure. Combining drugs with complementary mechanisms of action may improve both blood pressure control and the tolerability of individual drugs. A number of fixed-dose combinations have shown efficacy in older patients and in stage 2 hypertension, including various combinations involving diuretics and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers.
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L. Michael Prisant (2008) studied this question.
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