Related Experiment Videos

Amlodipine monotherapy vs. amlodipine-ARB combination therapy as first-line treatment for primary hypertension: a

Yusra Pintaningrum1, Claresta Salsabila Putri Evianto1, Romi Ermawan1

  • 1Faculty of Medicine and Health Sciences, University of Mataram, Mataram, Indonesia.

Frontiers in Cardiovascular Medicine
|May 8, 2026
PubMed

Insights

Combination therapy with amlodipine and an angiotensin receptor blocker (ARB) significantly improves blood pressure control compared to amlodipine monotherapy. This combination also shows a trend towards fewer adverse events in patients with primary hypertension.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Clinical guidelines suggest combination antihypertensive therapy over monotherapy.
  • Many hypertension patients need multiple drugs for target blood pressure.
  • The comparative risks and benefits of combination vs. monotherapy initiation are unclear.

Purpose of the Study:

  • To compare amlodipine monotherapy with first-line amlodipine and ARB combination therapy.
  • To assess blood pressure control efficacy.
  • To evaluate drug-related adverse events in primary hypertension.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched PubMed, PubMed Central, and Cochrane Library up to November 15, 2025.
  • Included trials comparing amlodipine monotherapy vs. amlodipine + ARB combination therapy for ≥8 weeks.

Main Results:

  • Combination therapy showed a 2.25-fold higher odds ratio for blood pressure control (P < 0.00001).
  • The risk ratio for adverse events was 0.93, indicating no statistically significant difference (P = 0.24).
  • Six studies were included in the meta-analysis.

Conclusions:

  • Combination therapy with a Calcium Channel Blocker (CCB) and an ARB significantly increases the likelihood of achieving blood pressure control.
  • Combination therapy demonstrated a trend towards lower drug-related adverse events compared to CCB monotherapy.
  • This suggests combination therapy may be a more effective first-line approach for hypertension management.
Abstract

Keywords:
amlodipinecombination therapyfirst-line therapymonotherapyprimary hypertension

Related Concept Videos

Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...