Why the study?
Does combining a calcium antagonist with an ACE-inhibitor or ARB improve blood pressure control and tolerability in patients with hypertension?
Does combining a calcium antagonist with an ACE-inhibitor or ARB improve blood pressure control and tolerability in patients with hypertension?
Combining calcium antagonists with ACE inhibitors or ARBs provides effective blood pressure control and good tolerability, facilitating long-term adherence and end-organ protection.
Supports calcium antagonist plus ACEI/ARB combinations for hypertension; extends prior data but leaves open prospective confirmation.
Pharmacological treatment of hypertension is effective in preventing cardiovascular and renal complications. Calcium antagonists (CAs) and blockers of the renin-angiotensin system [angiotensin-converting enzyme (ACE) inhibitors and angiotensin II antagonists (ARBs)] are widely used today to initiate antihypertensive treatment but, when given as monotherapy, do not suffice in most patients to normalise blood pressure (BP). Combining a CA and either an ACE-inhibitor or an ARB considerably increases the antihypertensive efficacy, but not at the expense of a deterioration of tolerability. Several fixed-dose combinations are available (CA + ACE-inhibitors: amlodipine + benazepril, felodipine + ramipril, verapamil + trandolapril; CA + ARB: amlodipine + valsartan). They are expected not only to improve BP control, but also to facilitate long-term adherence with antihypertensive therapy, thereby providing maximal protection against the cardiovascular and renal damage caused by high BP.
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Gojanovic et al. (2008) studied this question.
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