Combination therapy with beta-adrenergic blockade and amlodipine as second line treatment in essential hypertension.
In hypertension both beta-blockers and calcium antagonists are drugs with proved efficacy. Because only half the patients respond to a single drug, even at full dosage, a second hypotensive agent is frequently required to obtain adequate blood pressure control. The combination of a dihydropyridine calcium antagonist and a beta-blocker can be justified by their different mechanisms of action. A randomised double blind parallel group study versus placebo was performed, in order to assess the efficacy of atenolol combined with amlodipine in the treatment of stage I-II essential hypertension not controlled by atenolol alone. Twenty-four-hour arterial blood pressure monitoring showed that amlodipine added to atenolol produced a statistically significant reduction of blood pressure values compared with placebo in patients whose blood pressure was not controlled by atenolol alone. Blood pressure circadian rhythm was unchanged. The reduction of side-effects, obtained by adding a dihydropyridine derivate to a beta-blocker, confirms the effectiveness of this combination.
Mettimano
M
M
Department of Internal Medicine, Catholic University of Rome, Italy.
Pichetti
F
F
Fazzari
L
L
Migneco
A
A
Specchia
L
L
Romano Spica
V
V
Savi
L
L
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D017311:Amlodipine / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D017311:Amlodipine; D001262:Atenolol