Concomitant calcium entry blockade and inhibition of the renin-angiotensin system: a rational and effective means for treating hypertension

J Renin Angiotensin Aldosterone Syst. 2008 Mar;9(1):1-9. doi: 10.3317/jraas.2008.007.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Angiotensin II / antagonists & inhibitors
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Atenolol / administration & dosage
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use*
  • Drug Combinations
  • Drug Therapy, Combination
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use
  • Humans
  • Hypertension / drug therapy*
  • Indoles / administration & dosage
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Renin-Angiotensin System / drug effects*
  • Sympathetic Nervous System / drug effects
  • Verapamil / administration & dosage

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Calcium Channel Blockers
  • Drug Combinations
  • Enzyme Inhibitors
  • Indoles
  • Angiotensin II
  • trandolapril
  • Atenolol
  • Verapamil