Very-low-dose combination of perindopril and indapamide as a novel strategy in first-line management of hypertension.

Most patients with hypertension will need, at some stage, more than one drug to lower their blood pressure. Although monotherapy is still the preferred option for first-line treatment of hypertension, low-dose combination therapy as the initial medication has been increasingly recommended by National and International Guidelines. The use of perindopril/indapamide is an example of such a combination which contains 2 mg of the angiotensin converting enzyme inhibitor perindopril and 0.625 mg of the diuretic indapamide, these doses being respectively half and a quarter of the usual doses in monotherapy. This combination appears to lower blood pressure effectively with a good safety profile. It can be used in the elderly and also in patients with reduced renal function. Studies are underway to assess its efficacy on target organ damage.