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Single pill combination is the latest recommended

strategy for hypertension initial therapy

1 Pill Initial therapy ACEi or ARB + CCB or diuretic
Dual combination
Consider ACEi/ARB + Diuretic in:
post-stroke, very elderly,
incipient HF, CCB intolerance

1 Pill Step 2 ACEi or ARB + CCB + diuretic
Triple combination

Step 3 Resistant hypertension
2 Pill Triple combination Add spironolactone (25–50 mg o.d.)
or other diuretic, alpha-blocker or
+ spironolactone
or other drug beta-blocker

Beta-blockers: Consider beta-blockers at any treatment step, when there is a specific indication for their use, e.g. heart failure,
angina, post-MI, atrial fibrillation, or younger women with, or planning, pregnancy

Eur Heart J. 2018;39:3021-3104.