Calcium channel blockers in patients with both hypertension and angina pectoris

Abstract

Systemic hypertension is a risk factor for cardiovascular disease development and an aggravating factor once symptomatic coronary artery disease occurs. Some drugs that reduce high blood pressure may increase cardiovascular disease risk by altering serum electrolyte levels and/or plasma lipids. beta-Adrenergic blockers are useful agents for treating patients with both hypertension and angina pectoris, but their use may be limited by adverse reactions and/or contraindications to this type of therapy. Calcium entry blockers are a useful alternative to beta-blockers. In a placebo run-in, randomized, double-blind, crossover trial, propranolol and verapamil were found to be equally effective in reducing angina attacks and nitroglycerin consumption, while improving exercise tolerance. In another study with a similar design, both nifedipine and diltiazem were shown to be effective antianginal and antihypertensive drugs, with no differences in efficacy between them. Both calcium entry blockers and beta-blockers are effective treatments for patients with both angina and hypertension. The choice of a specific treatment will depend on the clinical and hemodynamic requirements of the individual patient.