Combined use of calcium channel blockers and inhibitors of the renin–angiotensin system for treating hypertension

Reduced cardiovascular events and mortality have been reported for hypertensive subjects treated with dihydropyridine-type calcium channel blockers (CCBs) and inhibitors of the renin–angiotensin system (RAS) in clinical trials. Recent evidence suggests that these agents may have vascular benefits that cannot be attributed to the reduction of blood pressure alone. Dihydropyridine-type CCBs and RAS blockers have been shown to improve endothelial activity while reducing inflammation. These changes in vascular activity have been confirmed by pulse wave analyses, which show a reduced impact of pressure wave reflections on central systolic blood pressure. In this article, we examine the separate and combined effects of CCB and RAS inhibition in reducing cardiovascular risk through enhanced vascular function.