Combinations in the treatment of hypertension: ACE inhibitors and calcium antagonists.
Hypertension control and management of concomitant pathophysiologic conditions may require use of multiple drugs. However, most studies in hypertensive disease have focused on monotherapy. Therefore, our knowledge of combination therapy in the treatment of hypertension is largely extrapolated from these monotherapy studies. Angiotensin-converting enzyme (ACE) inhibitors and calcium antagonist combinations should be particularly efficacious in reducing hypertensive target organ disease. Both of these drug classes have been shown to reduce complications of hypertensive heart disease and renal disease progression. With regard to hypertensive vascular disease, both ACE inhibitors and calcium antagonists have documented benefits. However, their use together in left ventricular hypertrophy and in patients with coronary heart disease, although promising, must be proved through carefully designed, prospective, randomized trials.
Messerli
F H
FH
Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana, USA.
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000494:pharmacology; D002319:Cardiovascular System / Q000187:drug effects; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000517:prevention & control; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006321:Heart / Q000187:drug effects; D006333:Heart Failure / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control; D007668:Kidney / Q000187:drug effects; D011446:Prospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers