Dihydropyridines and beta-adrenoceptor antagonists as combination treatment in hypertension

The combination of one of the dihydropyridine class of calcium channel antagonists with a beta-adrenoceptor blocker has particular therapeutic advantages in the management of hypertension. The beta-blocker reduces the effects of the dihydropyridine-induced reflex increases in sympathetic nervous system and renin-angiotensin system activity, while the dihydropyridine reduces the peripheral effects of beta-blockade. Numerous studies have documented additional antihypertensive effects when these two classes of agents are used as combination therapy in hypertension. This therapeutic combination is well tolerated and produces minimal alterations in clinical laboratory tests. Initial concerns that the combination may impair atrioventricular conduction and left ventricular function have not been substantiated in widespread clinical trials.