Why the study?
Does oral nitrendipine and propranolol, alone or in combination, affect AV conduction in patients with essential hypertension?
Does oral nitrendipine and propranolol, alone or in combination, affect AV conduction in patients with essential hypertension?
The combination of nitrendipine and propranolol in hypertensive patients does not cause clinically significant impairment of AV conduction.
Supports safe nitrendipine-propranolol co-use in hypertension without clinically relevant AV delay; confirms differential PR effects remain within normal limits.
The effects of oral nitrendipine and oral propranolol, alone and in combination, on AV conduction have been examined in 11 patients with essential hypertension in whom arterial pressure was not adequately controlled despite treatment with thiazide diuretics. The study was performed double-blind. After a drug free period of 1 week, the patients received two 7 day courses of drug therapy after initial control measurements. Five of the eleven patients were randomised to receive nitrendipine 20 mg daily, the other six patients received propranolol (Inderal LA 160 mg daily) for the first week of therapy. During week 2, 10 patients received combined therapy. In the 10 patients who completed the study, oral nitrendipine, given either alone or in combination with oral propranolol, had no significant effect on resting PR, QRS, QT intervals nor on AV conduction as assessed by ambulatory electrocardiography. Propranolol did not affect the resting PR interval but significantly increased PR intervals on the ambulatory ECG recordings during single and combined therapy. However the maximum PR intervals remained within normal limits.
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Maltz et al. (1986) studied this question.
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