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Nitrendipine and ACE inhibitors.

¹Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.

Journal of Cardiovascular Pharmacology

|January 1, 1988

Summary

Combining calcium antagonists and angiotensin converting enzyme (ACE) inhibitors offers clinical benefits for hypertension management. This combination potentiates therapeutic effects through multiple mechanisms, enhancing blood pressure control.

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Area of Science:

Pharmacology
Cardiovascular Medicine
Internal Medicine

Background:

Clinical studies demonstrate the utility of combining calcium antagonists and angiotensin converting enzyme (ACE) inhibitors for hypertension.
Understanding the synergistic mechanisms between these drug classes is crucial for optimizing antihypertensive therapy.

Purpose of the Study:

To elucidate the multifaceted mechanisms underlying the mutual potentiation of calcium antagonists and ACE inhibitors.
To review the current understanding of optimal dosing strategies for combined antihypertensive therapy.

Main Methods:

Review of existing clinical studies and pharmacological data.
Analysis of proposed mechanisms of drug interaction and potentiation.
Discussion of the limited information on optimal dose combinations.

Main Results:

Calcium antagonists can cause reflex sympathetic activation, which is counteracted by ACE inhibitors.
Combined therapy may lead to more balanced arteriolar and venous dilatation compared to calcium antagonists alone.
Dihydropyridines facilitate renin release and angiotensin II generation, which is subsequently blocked by ACE inhibitors.

Conclusions:

The combination of calcium antagonists and ACE inhibitors offers significant clinical benefits in hypertension treatment due to multiple synergistic mechanisms.
Further research is needed to establish optimal dose-response relationships and combinations, especially for fixed-dose formulations.

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