Effect of a calcium-channel blocker and β-blocker combination on reading-to-reading blood pressure variability: a...

Area of Science:

• Cardiology
• Pharmacology

Background:

• Hypertension management often involves combination therapy to achieve optimal blood pressure control.
• Blood pressure variability (BPV) is an emerging risk factor for cardiovascular events.
• Assessing BPV using ambulatory blood pressure monitoring (ABPM) provides valuable insights into treatment efficacy.

Purpose of the Study:

• To compare the efficacy of a nitrendipine/atenolol combination with monotherapy using standard doses of either drug.
• To evaluate the impact of these treatments on both blood pressure (BP) and blood pressure variability (BPV).
• To assess BP and BPV using ambulatory blood pressure monitoring.

Main Methods:

• A randomized, crossover trial involving 32 patients (30-65 years) with grade 1 hypertension and elevated daytime BPV.
• Patients received either the nitrendipine/atenolol combination (10/20 mg) or monotherapy (nitrendipine 10 mg or atenolol 25 mg) for 6 weeks, followed by a crossover.
• Ambulatory blood pressure monitoring was used to assess BP and BPV.

Main Results:

• The nitrendipine/atenolol combination significantly reduced clinic and ambulatory BP and pulse rate from baseline.
• Significant reductions in 24-hour and daytime systolic and diastolic BPV were observed with the combination therapy.
• No significant differences in BPV were found between the combination and monotherapy groups at the end of treatment.

Conclusions:

• The nitrendipine/atenolol combination effectively reduced daytime reading-to-reading blood pressure variability.
• The combination therapy did not demonstrate superiority over standard-dose nitrendipine or atenolol monotherapy in overall efficacy.
• Further research may be needed to fully elucidate the role of combination therapy in managing BPV.