Calcium Antagonists in Antihypertensive Combination Therapy

Calcium antagonists can be used with a number of other antihypertensive compounds. The combined use of a dihydropyridine calcium antagonist and beta-blocker is well established and is probably the most efficacious combination for routine use. Angiotensin-converting enzyme (ACE) inhibitors may also constitute a suitable addition to calcium antagonist therapy, whereas little benefit appears to be derived from the combined use of a calcium antagonist and a diuretic. Other compounds, e.g., alpha-adrenoceptor blockers, can also be given together with calcium antagonists, although this should be done with great caution because dramatic reductions in blood pressure may result. It is worth noting that in addition to the improved antihypertensive efficacy produced by some of the calcium antagonist combinations, potentially positive metabolic changes may also occur, e.g., a reduction in serum cholesterol, when a calcium antagonist and a beta-blocker are combined.