Editor’s note: Recently, the European Society of Cardiology and the European Society of Hypertension published updated guidelines for hypertension, and the new guidelines were changed based on the results of several large clinical trials and studies. In terms of combination therapy, the new guidelines combine the results of the ADVANCE trial, the FEVER study and the ACCOMPLISH study to provide a hierarchy of recommendations for multiple combination regimens. The author extracts some of the important contents for the readers. The following chart shows that the new guidelines recommend five combination regimens as the preferred combination: thiazide diuretics combined with angiotensin receptor antagonists; thiazide diuretics combined with calcium antagonists; thiazide diuretics combined with angiotensin converting enzyme inhibitors; calcium antagonists combined with angiotensin converting enzyme inhibitors; and calcium antagonists combined with angiotensin receptor antagonists. The combination of ACEI drugs and angiotensin receptor antagonists is not recommended. Note: Although verapamil and diltiazem are sometimes used clinically in combination with beta-blockers to improve ventricular rate control in patients with permanent atrial fibrillation, in general beta-blockers should only be used in combination with dihydropyridine calcium antagonists. The data in the table below show that all combinations, except for one angiotensin receptor antagonist and calcium antagonist (which was never systematically used in a clinical progression trial), have been validated in at least one controlled trial. Comparing the trials with different combinations, each combination was more or less used in the patient population and there were no significant differences in efficacy. The exceptions were two trials in which the majority of patients received either the “ACEI + diuretic” or “calcium antagonist + ACEI” combination, both of which were found to be superior to the “beta-blocker” combination in reducing cardiovascular events. The combination of “beta-blocker + diuretic” was found to be superior to “beta-blocker + diuretic” in reducing cardiovascular events. There is no doubt that the “beta-blocker + diuretic” combination was no worse than other combinations in several other studies, and three studies confirmed the combination’s efficacy over the placebo group. However, it should be noted that the combination “beta-blocker + diuretic” caused more new cases of diabetes than other combinations in people susceptible to diabetes. Note: ACE-I = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor antagonist; BB = beta-blocker; CA = calcium antagonist; CHD = coronary artery disease; CV = cardiovascular; D = diuretic; ISH = simple systolic hypertension; LVH = left ventricular hypertrophy; NS = not significant; RAS = renin-angiotensin system; TIA = TIA = diuretic. -angiotensin system; TIA=transient ischemic attack.