Combinations in the treatment of hypertension: ACE inhibitors and calcium antagonists

Hypertension control and management of concomitant pathophysiologic conditions may require use of multiple drugs. However, most studies in hypertensive disease have focused on monotherapy. Therefore, our knowledge of combination therapy in the treatment of hypertension is largely extrapolated from these monotherapy studies. Angiotensin-converting enzyme (ACE) inhibitors and calcium antagonist combinations should be particularly efficacious in reducing hypertensive target organ disease. Both of these drug classes have been shown to reduce complications of hypertensive heart disease and renal disease progression. With regard to hypertensive vascular disease, both ACE inhibitors and calcium antagonists have documented benefits. However, their use together in left ventricular hypertrophy and in patients with coronary heart disease, although promising, must be proved through carefully designed, prospective, randomized trials.