Combination therapy of hypertension with beta-adrenoceptor blockers and the calcium channel antagonist nitrendipine.

The combination of a beta-adrenoceptor-blocking drug with the dihydropyridine calcium channel antagonist, nitrendipine, has particular therapeutic advantages in the management of hypertension. The beta-blocker reduces any reflex increases in sympathetic nervous system and renin-angiotensin system activity that result from the vasodilating action of nitrendipine, whereas the latter drug reduces the peripheral effects of beta-blockade. At least three clinical studies have documented additional hypotensive effects when nitrendipine is used in combination with beta-blockers in the treatment of hypertension. This therapeutic combination is well tolerated, produces minimal alterations in clinical laboratory tests, and does not produce significant depression of atrioventricular conduction or left ventricular function.