Summary: The current guidelines emphasize the necessity to use combination therapy from the beginning of therapy with the use of single pill combinations (SPCs) based on 2 and 3 antihypertensive drugs. The availability of SPCs based on two- and three-drug combinations based on the same drug that inhibits the renin-angiotensin system allows therapy with one tablet through its first stages. The limited number of clinical situations in which treatment can be started with monotherapy (very advanced age, fragile syndrome, first degree hypertension and low cardiovascular risk) and the numerous benefits of basing the therapy on SPCs indicate that SPCs are its inseparable element, from which there is no turning back.