Role of fixed combinations in modern treatment of arterial hypertension: new or well overlooked old?

The article discusses therapeutic tactics changes and arterial hypertension (AH) treatment algorithms stated in latest European Society of Hypertension and European Society of Cardiology guidelines (ESH/ESC 2018). Causes of therapeutic strategies ineffectiveness are analyzed: therapeutical persistency, insufficient use of combined therapy, treatment adherence problems, and “complexity” of therapeutic strategies used. Stages of combined AH therapy history and treatment with fixed combinations renaissance in the 1990s are described. Special attention is given to triple-component fixed combination for AH treatment. Therapeutic strategy of rapid change to triple-component antihypertensive therapy in case of double-component schemes non-effectiveness is explained. The latest expert consensus, mataanalyses, and studies explaining fundamental principles of AH control increase in population are presented. Mechanisms of AH treatment adherence increase are analyzed. Results of the latest study of amlodipine/indapamide/perindopril fixed combination use effectiveness, safety, and treatment adherence are analyzed independently.