Reduction of cardiovascular risk frequently requires the co-administration of multiple antihypertensive (AH) and lipid lowering (LL) drugs. Fixed combinations of two drugs could improve daily compliance by simplifying the treatment regimen. OBJECTIVE: To assess which antihypertensive patients might benefit from a combination of AH and LL drugs. METHODS: Hypertensive patients (>=30 years plus >=3 cardiovascular risk factors or events (CVD), experienced or new users of antihypertensive drugs between June 2003-June 2004)were selected from the IPCI database in the Netherlands. A written questionnaire was administered in October 2005 regarding reasons for non-compliance, likelihood of missing a dose if two pills would be combined in one, and self-reported medication-taking. Percentage of days covered (PDC) with AH medication was calculated from the prescription records. RESULTS: A total of 729 out of 1473 patients responded, 101 were new users of antihypertensive drugs, 349 had CVD. Respondents (75% male, median age 63 years) used on average 3 drugs, and 40% used LL drugs at start of follow-up. Side effects, lack of efficacy, and forgetting scored highest as reasons for not taking medications as prescribed. The median PDC for antihypertensive drugs was 57%, less than 40% had PDC >80%, with newly treated hypertensive patients commonly =<80% PDC. 35% would be less likely or much less likely to miss a dose if two pills would be combined in one tablet, this likelihood was independent of CVD, experienced or new use and calculated PDC levels. Perceived likeliness to benefit from a combined tablet was significantly higher in persons taking fewer AH drugs, and patients self-reporting taking =<20% of doses. CONCLUSION: Patients newly treated with antihypertensive drugs and additional cardiovascular risk factors may benefit most from a fixed combination of two cardiovascular risk reducing drugs in one pill since they express more partial adherence and use fewer tablets.