Hypertension Update: Amlodipine and Atenolol: Combination Therapy Versus Monotherapy for blood pressure Management


eMediNexus    07 August 2021

BetaCardiovascular diseases remain a serious public health challenge that affects an unlimited majority of the population across the world. Among the numerous risk factors for cardiovascular diseases, the foremost important modifiable risk factor is hypertension.

The usefulness and efficacy of antihypertensive medication are studied for many years. There are many placebo-controlled trials and meta-analyses that have proven that the treatment with antihypertensive can prevent and postpone myocardial infarction and stroke. Among the foremost popular drugs in this category are amlodipine and atenolol.

The researchers have now come up with the thought of combining multiple classes of antihypertensive drugs to attain good and fast blood pressure control in most hypertensive patients. Combination therapy has proven to be superior compared with monotherapy within the following regards-

  • A synergistic effect of individual drug’s therapeutic effects on combining
  • Lesser side effects due to lower dose of each drug.

Amlodipine and Atenolol: Combination therapy:

The combination of two drugs offers novel approaches for treatment within the otherwise difficult-to-control hypertensive patient.

Amlodipine and atenolol are reported to scale back mean blood pressure on an assessment by a non-imaging Echo-Doppler cardiac output device, in patients with essential hypertension.

Amlodipine, a calcium channel blocker, shows a gradual onset of action and prolonged half-life that contributes to little or no reflex tachycardia. These properties may help suppress ischemia, both alone and with a beta-blocker.

A 12-week study regarded once-daily treatment with atenolol/amlodipine fixed-dose combination to possess superior antihypertensive efficacy over atenolol monotherapy. Another study stated that the addition of amlodipine to atenolol shows lower pressure values than placebo or atenolol monotherapy. Also, the side effects of adding amlodipine to a beta-blocker are much less which confirms the effectiveness of this combination.

It was observed in a study that the relative risk of developing constipation is 4 fold more in patients on amlodipine monotherapy comparing to those patients taking a combination of amlodipine and atenolol. 

Medication compliance could be a key for the successful management of chronic conditions. Fixed drug combinations (FDC) simplify the medication regimens and help improve drug compliance.

With this regard, a combination of most acceptable/ prescribed drugs like amlodipine with atenolol may emerge as a good choice with proven cardiovascular benefits and adequate hypertension control. It is surely superior to monotherapy with similar drugs in patients with mild-to-moderate hypertension.

Source: Sharma D, Mehta DK, Bhatti K, Das R, Chidurala RM. Amlodipine And Atenolol: Combination Therapy Versus Monotherapy In Reducing Blood Pressure - A Focus On Safety And Efficacy. Research J. Pharm. and Tech 2020; 13(6): 3007-3013. doi: 10.5958/0974-360X.2020.00532.6

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