Cardiovascular disease is the leading cause of mortality worldwide, affecting a wide range of patients at different stages across the cardiovascular continuum. Hypertension is one of the earliest risk factors in this continuum and can be controlled in most patients with currently available antihypertensive agents. However, goals are often not met because treatments are not optimized in terms of tailoring therapy to individual patients based on their hypertension subclass and cardiovascular risk profile and initiating early use of adapted-dose, single-pill combinations. In this context, beta-blockers in combination with angiotensin-converting enzyme (ACE) inhibitors are of special interest as a result of their complementary actions on the sympathetic nervous system and renin–angiotensin–aldosterone system, two interlinked pathways that influence cardiovascular risk and disease outcomes. In addition to their antihypertensive actions, beta-blockers are used to manage arrhythmias and treat angina pectoris and heart failure, while ACE inhibitors provide cardioprotection in patients with acute coronary syndromes and treat congestive heart failure. A broad range of patients may therefore receive the combination in routine clinical practice. This paper examines the supporting evidence for beta-blockers and ACE inhibitors in each of the above indications and considers the rationale for combining these agents into a single pill, using data from bisoprolol and perindopril randomized controlled trials as supporting evidence. Combining these established antihypertensive agents into a single pill continues to provide effective blood pressure lowering and improved cardiovascular outcomes while allowing a greater proportion of patients to rapidly achieve treatment targets.

心血管疾病是全世界死亡的主要原因，影响着整个心血管系统不同阶段的广大患者。高血压是该连续体中最早的危险因素之一，大多数患者可以使用目前可用的抗高血压药物进行控制。然而，目标常常无法实现，因为在根据患者的高血压亚类和心血管风险状况为个体患者量身定制治疗以及开始早期使用调整剂量的单药组合方面，治疗并未得到优化。在这种情况下，β-受体阻滞剂与血管紧张素转换酶（ACE）抑制剂联合使用特别令人感兴趣，因为它们对交感神经系统和肾素-血管紧张素-醛固酮系统具有互补作用，这两个相互关联的途径影响心血管风险和疾病结果。除了抗高血压作用外，β-受体阻滞剂还用于控制心律失常、治疗心绞痛和心力衰竭，而 ACE 抑制剂则为急性冠脉综合征患者提供心脏保护作用并治疗充血性心力衰竭。因此，广泛的患者可以在常规临床实践中接受该组合治疗。本文研究了 β 受体阻滞剂和 ACE 抑制剂在上述每种适应症中的支持证据，并使用比索洛尔和培哚普利随机对照试验的数据作为支持证据，考虑了将这些药物组合成单一药物的基本原理。将这些已建立的抗高血压药物组合成单一药丸，可继续有效降低血压并改善心血管结局，同时使更多患者能够快速实现治疗目标。