Mohammad Idrees

Abstract Hypertension is a leading cause of cardiovascular morbidity and mortality, yet the management remains suboptimal especially with monotherapy. Recently, low-dose triple and quadruple (quadpill) combinations have emerged as a promising therapeutic advancement resulting in control of hypertension. However, there still remains controversy around the long-term safety and efficacy of these therapies.

1 Introduction Hypertension is the most common modifiable cause of cardiovascular death worldwide, yet many patients do not achieve target blood pressure despite multidrug therapy [1-3]. Treatment-resistant hypertension is defined as persistently elevated blood pressure despite treatment with at least three antihypertensive agents at maximally tolerated doses, including a diuretic. This phenotype is associated with higher risks of stroke, heart failure, chronic kidney disease, and death.