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Review: Concomitant calcium entry blockade and inhibition of the renin-angiotensin system: a rational and effective means for treating hypertension

Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland

François Feihl

Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland

Lucas Liaudet

Service of Adult Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland

Bernard Waeber

Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Lausanne, Switzerland, Bernard.Waeber @chuv.ch

Pharmacological treatment of hypertension is effective in preventing cardiovascular and renal complications. Calcium antagonists (CAs) and blockers of the renin-angiotensin system [angiotensin-converting enzyme (ACE) inhibitors and angiotensin II antagonists (ARBs)] are widely used today to initiate antihypertensive treatment but, when given as monotherapy, do not suffice in most patients to normalise blood pressure (BP). Combining a CA and either an ACE-inhibitor or an ARB considerably increases the antihypertensive efficacy, but not at the expense of a deterioration of tolerability. Several fixed-dose combinations are available (CA + ACE-inhibitors: amlodipine + benazepril, felodipine + ramipril, verapamil + trandolapril; CA + ARB: amlodipine + valsartan). They are expected not only to improve BP control, but also to facilitate long-term adherence with ON antihypertensive therapy, thereby providing renal damage caused by high BP. maximal protection against the cardiovascular and renal damage caused by high BP.

Key Words: angiotensin-converting enzyme inhibitors • angiotensin II • antagonists • calcium antagonists • guidelines • hypertensin • tolerability

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Journal of Renin-Angiotensin-Aldosterone System, Vol. 9, No. 1, 1-9 (2008)
DOI: 10.3317/jraas.2008.007


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