Key result
Antihypertensive combination therapy reaches ~66% of treated patients, far outpacing monotherapy.
Why the study?
Most patients with arterial hypertension require combination therapy with two or more drugs for adequate blood pressure control, motivating a nationwide analysis of antihypertensive treatment use in the Czech Republic.
Cross-Sectional (n=2,233,180)
Yes
This nationwide registry analysis demonstrates a high real-world uptake of guideline-recommended antihypertensive combination therapy (66%) and fixed-dose combinations (~60% across major classes) in the Czech Republic, exceeding contemporary European estimates.
Common combination antihypertensive use warrants practice monitoring; extends large observational data but leaves optimal regimens open.
Introduction Arterial hypertension is a major health risk factor. To achieve adequate blood pressure control, most patients require combination therapy with two or more drugs. Purpose The aim of this study was to analyse the nationwide use of antihypertensive treatment in the Czech Republic. Methodology Nationwide data on all patients treated for arterial hypertension in 2023 in the Czech Republic were obtained from the National Registry of Reimbursable Health Services (NRHZS). Patients who received the diagnosis code I10 as a primary or secondary diagnosis during hospitalization or outpatient care within this period and who were prescribed any antihypertensive drug from selected ATC groups (C02, C03, C07, C08, C09, C10BX) were classified as having treated arterial hypertension. Descriptive statistics were used to evaluate the outcomes. Results The total number of patients with treated hypertension was 2,233,180 (20,529 per 100,000 inhabitants), and there were 157,203 newly incident patients (1,445 per 100,000 inhabitants) in 2023. Of these, 51% were women; the mean age was 69 ± 13 years, and 59.8% of patients were aged ≥65 years. Most antihypertensive drugs (75%) were prescribed by general practitioners, followed by internists (10%), cardiologists (10%), and other specialists (5%). Treatment with all four major classes of antihypertensive drugs and their combinations is shown in the Figure. Overall, 23.6% of patients were treated with a single drug, 27.2% with two drugs, 27.5% with three drugs, and 11.5% with four antihypertensive drugs. The proportion of fixed-dose combination use was 58.5% for ACE inhibitors/angiotensin receptor blockers, 61.6% for calcium channel blockers, 66.7% for diuretics, and 6.4% for beta-blockers. Conclusions In 2023, two thirds of patients (66%) in the Czech Republic were treated with two or more antihypertensive drugs. Both the high prevalence of combination therapy and the approximately 60% use of fixed-dose combinations across most drug classes were substantially higher than contemporary European estimates. Combinations of antihypertensive drugs
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Vaclavik et al. (2026) conducted a cross-sectional in Arterial hypertension (n=2,233,180). Antihypertensive combination therapy vs. Antihypertensive monotherapy was evaluated on Prevalence of combination antihypertensive therapy use (two or more drugs). Antihypertensive combination therapy (two or more drugs) was prescribed to 66% of treated hypertensive patients in the Czech Republic in 2023, compared with 23.6% receiving monotherapy.
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