he importance of combination therapy to reach the target blood pressure. In patients needing 3-4 drugs and he would prefer a diuretic as a third drug of choice.
In two other studies, doctors used the combination of two drugs, one to lower blood pressure and another to lower cholesterol. 50% 0f people with hypertension also have high blood cholesterol, another risk factor for the heart, according to John Kostis, Professor of medicine and pharmacology at the University of Medicine and Dentistry of New Jersey, New Brunswick.
Literature in TNT (Treating to New Targets) states that LDL cholesterol levels and blood pressure were low in people with lower cardiovascular problems (MI, CVA, need for relieving angina) said John Kostis.
He treated his patients with a combination of Norvasc and Lipitor (Atorvastatin).
In a study on African Americans, John Flack professor of medicine at Wayne State University, Detroit, used similar drugs. He used Caduet (combination of Norvasc and Lipitor) in people with mild / moderate / high hypertension.
48.3% patients could achieve normal blood pressure and normal cholesterol levels, 73.7 % could reach normal cholesterol levels and 56.8% could reach normal blood pressure levels on Cauduet.
Jan Basile, professor of medicine at the Medical University of South Carolina, Charleston stressed the need to review these studies and the commencement of combination therapy for the patients.
According to Flack, some doctors practice monotherapy and do not add/change the drug even in patients who continue to have high blood pressure.
He further stressed the need to get over physician / therapeutic inertia which is the biggest problem in cardiovascular management in tough to treat groups (diabetics and African Americans).
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