furosemide + hydralazine + metoprolol

This is a combination therapy consisting of three antihypertensive agents: - **Furosemide** is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending limb of the loop of Henle, leading to increased urine output and reduction in blood volume. It is primarily used for treating edema associated with heart failure, liver cirrhosis, renal disease, and as an adjunct in hypertension[3]. - **Hydralazine** is a direct-acting vasodilator that relaxes arteriolar smooth muscle by interfering with calcium movement within vascular smooth muscle cells. This results in decreased peripheral resistance and lowered blood pressure. Hydralazine is mainly indicated for moderate to severe hypertension. - **Metoprolol** is a selective beta-1 adrenergic receptor blocker (beta-blocker) that reduces heart rate, cardiac output, and renin release from the kidneys. It lowers blood pressure by decreasing sympathetic stimulation on the cardiovascular system[8]. The combination may be used when monotherapy or dual therapy does not achieve adequate blood pressure control or when there are compelling indications for each agent (e.g., heart failure with hypertension). Each drug targets different mechanisms involved in hypertension management.