Figure 753

Combination therapies. If a second drug is required, the addition of a low-dose thiazide-type diuretic to a nondiuretic drug will usually enhance the effectiveness of the first drug [6,9,17]. Newly developed formulations, using combinations of low doses of two agents from different classes, are available and effective and may minimize the likelihood of a dose-dependent adverse effect. The fixed doses used in these formulations were chosen to control mild to moderate (JNC VI stage 1 or 2) hypertension. More severe (JNC VI stage 3) cases of hypertension that are unresponsive to this therapeutic strategy may respond either to a variety of combination therapies given together as separate formulations or to classic triple-drug therapy (ie, diuretic, ^-adrenergic antagonist, and direct-acting vasodilator) [6,9]. ACE—angiotensin-converting enzyme; JNC—Joint National Committee.

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