Review: Calcium channel blockade in combination with angiotensin-converting enzyme inhibition or angiotensin II (AT1-receptor) antagonism in hypertensive diabetics and patients with renal disease and hypertension

Abstract

Effective reduction in blood pressure (BP) improves survival and morbidity in hypertensive patients. Combination therapy with multiple antihypertensive agents is frequently required in clinical practice and therapeutic trials to achieve target BP. Patients at elevated cardiovascular risk achieve the greatest benefit from equivalent reduction in BP and also require more stringent BP control. In patients with hypertension and diabetes mellitus or renal disease, BP control is of primary importance and blockade of the renin-angiotensin system (RAS) should be the initial therapeutic intervention. Choice of combination therapy has been insufficiently studied in major clinical cardiovascular endpoint trials. Diuretic therapy remains the logical addition to RAS blockade. Despite previous debate, the available evidence suggests long-acting calcium-channel blockers are also a safe and very effective addition to improve BP control further. The choice of antihypertensive combination therapy should not override the fundamental necessity of lowering BP to target levels.

Study on the determination of felodipine sample content by fluorescence method and its application

“…Studies have shown that felodipine sustained-release tablets have a strong antihypertensive effect when used alone, and that felodipine sustained-release tablets combined with other anti-blood pressure have the advantages of high treatment compliance rate, safety, tolerance, and high compliance. [1][2][3] This product is easily soluble in acetone, methanol or ethanol, but almost insoluble in water. BSC class II drugs so far, felodipine sustained-release tablets have been marketed in the United States, Canada, the European Union and other countries, among which the original research manufacturer has withdrawn from the market in the United States, and a large number of imitation companies have emerged.…”

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“…The choice of combination therapy for diabetic hypertensive patients has been insufficiently studied in major clinical cardiovascular endpoint trials. Despite some contradictory findings, the available evidence suggests long-acting CCBs are safe and very effective as second antihypertensive drugs in combination therapy (73). Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) and the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) will determine the efficacy of amlodipine in type 2 diabetic patients with hypertension (67).…”