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Combination therapy with an angiotensin-converting enzyme inhibitor and a calcium channel blocker

Brent M Egan1

  • 1Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. eganbm@musc.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|October 6, 2007
PubMed

Insights

Many patients with hypertension require multiple medications. Initial combination therapy with two agents, such as ACE inhibitors and calcium channel blockers, may improve outcomes compared to other combinations.

Area of Science:

  • Cardiology
  • Pharmacology
  • Nephrology

Background:

  • Many hypertensive patients require more than one medication to achieve blood pressure goals.
  • Initial dual-agent therapy is recommended for those significantly above target blood pressure.
  • Combination therapy is crucial for managing hypertension and preventing target organ damage.

Purpose of the Study:

  • To compare the efficacy of ACE inhibitor/diuretic versus ACE inhibitor/calcium channel blocker combinations in hypertensive patients.
  • To evaluate the impact of these combinations on cardiovascular morbidity and mortality.
  • To clarify the relative benefits of different antihypertensive combination therapies.

Main Methods:

  • The ACCOMPLISH trial is a key study comparing ACE inhibitor/diuretic and ACE inhibitor/calcium channel blocker combinations.
  • The trial focuses on older, high-risk hypertensive patients.
  • Outcomes measured include cardiovascular morbidity and mortality.

Main Results:

  • The ACCOMPLISH trial results are pending and expected to provide significant insights.
  • Previous evidence suggests ACE inhibitor/calcium channel blocker combinations may offer superior cardiovascular and renal benefits.
  • This combination may also improve endothelial function.

Conclusions:

  • The choice of initial antihypertensive combination therapy can significantly impact patient outcomes.
  • Further results from trials like ACCOMPLISH are needed to guide clinical practice.
  • Optimizing combination therapy is essential for managing high-risk hypertensive populations.

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