Optimization of hypertension management: the role of angiotensin receptor blocker-calcium channel blockers combinations

The 2007 European Society of Hypertension-European Society of Cardiology guidelines on hypertension management placed increased emphasis on the need for obtaining satisfactory blood pressure (BP) control in all patients with high BP, and in particular in those with a higher cardiovascular risk. According to these guidelines, the majority of patients will require the use of combination antihypertensive treatment to achieve their BP goals. This review highlights the factors that should be considered when choosing a combination therapy, including efficacy, tolerability, metabolic effects, and additional organoprotective benefits. Several possible combinations are proposed by the European Society of Hypertension-European Society of Cardiology guidelines. Among them, the combination of angiotensin receptor antagonists with calcium channel blockers has been shown to provide well-tolerated antihypertensive efficacy, which is greater than that of monotherapy with either agent, and lacks adverse metabolic effects. The development of fixed-dose angiotensin receptor blocker-calcium channel blocker therapy offers additional benefits in terms of adherence to treatment. © 2009 Lippincott Williams & Wilkins, Inc