Hypertension/High Blood Pressure Health Center

Combination Treatment for Hypertension

Having blood pressure problems? If one medicine can't lower your blood pressure, your doctor may try combination treatment for hypertension.

Studies show that many people get better control of blood pressure with combination treatment than with one drug.

There are many medications that are used in combination to help control high blood pressure. The goal is clear: control hypertension and you can lower your risk of heart disease.

When is combination treatment for high blood pressure necessary?

Combination treatment means another class of blood pressure medication is added to the first drug to increase effectiveness.

Most people with mild high blood pressure respond to one medication. Sometimes it takes a few tries to find the most effective drug.

However, sometimes one drug cannot control high blood pressure. The doctor may increase the dose or change the medication, yet the blood pressure stays high. That's when a second drug may be added.

Sometimes patients with higher blood pressure need combination treatment -- even initially -- to bring it to a normal range.

Combination treatment for hypertension is individualized. It gives the best possible control of blood pressure with the fewest side effects.

Also, combination treatment may cost less. There may be less frequent doctor visits as the drug combo effectively manages the hypertension.

What combinations of drugs are used to treat high blood pressure?

Different combinations of drugs and in varying dosages are used to treat hypertension. Sometimes using lower doses of one or more drugs in combination can minimize side effects.

Thiazide diuretics may be used alone to treat hypertension. Yet low dose diuretics are also used with medications such as beta-blockers.

When used in a drug combo, the diuretic has fewer side effects. It also boosts the blood-pressure-lowering effect of the other medication.

Diuretics are added to other blood pressure medications. For instance, if the person with high blood pressure also retains fluid, a diuretic may be added.

ACE inhibitors or angiotensin receptor blockers are often effective when combined with other classes of medications.

Sometimes a beta-blocker is combined with an alpha-blocker. This may be useful for men who have hypertension and an enlarged prostate. The alpha-blocker may help both problems at the same time.

Other combinations may include an ACE inhibitor with a thiazide diuretic. Sometimes an angiotensin II receptor antagonist is combined with a diuretic. Or an ACE inhibitor may be combined with a calcium channel blocker.

Your doctor will prescribe combination treatment cautiously. For instance, if both drugs lower the heart rate, your doctor will monitor you closely. This will keep you from having an excessively slow pulse (called bradycardia).

If you have asthma, your doctor will avoid using drugs that could cause asthma-like symptoms. Trust your doctor to prescribe the most effective treatment with your health in mind.