Combination therapy with two different classes of calcium channel blockers provides additive blood pressure reduction and antianginal efficacy, though it remains a secondary treatment option.
Does combination therapy with two different calcium channel blockers improve blood pressure control or angina symptoms in patients with hypertension or coronary artery disease?
Combining two different classes of calcium channel blockers may offer additive blood pressure and antianginal benefits for patients failing monotherapy, but it remains a secondary option pending larger definitive trials.
Effective control of blood pressure is usually achieved only with the use of two or more antihypertensive medications. The treatment options for hypertension are numerous, and the number of possible combinations large. The selection of a specific combination drug regimen has often been linked to the perceived need for diuretic therapy as first- or second-step therapy; thus, the popularity of such drug combinations as an angiotensin-converting enzyme (ACE) inhibitor/diuretic, an angiotensin-receptor blocker/diuretic, or a beta blocker/diuretic. Rational alternatives exist, including an ACE inhibitor/calcium channel blocker (CCB) or a dihydropyridine CCB/b blocker combination. Traditionally, recommendations have advised against the use of combination therapy with two drugs from the same therapeutic class. However, because of the different binding and pharmacologic characteristics of CCBs, a rationale exists for combining different agents in this class in the management of hypertension and/or symptomatic coronary artery disease. In the treatment of either hypertension or angina, combination CCB therapy can prove uniquely successful.
Domenic A. Sica (Sat,) conducted a review in Hypertension and Angina Pectoris. Combination Calcium Channel Blocker Therapy vs. Calcium Channel Blocker Monotherapy was evaluated. Combination therapy with two different classes of calcium channel blockers provides additive blood pressure reduction and antianginal efficacy, though it remains a secondary treatment option.