Amlodipine Beta Blocker

Amlodipine and Beta Blockers: Combined Therapy for Cardiovascular Conditions

Introduction to Amlodipine and Beta Blockers

Amlodipine, a calcium channel blocker, and beta blockers are commonly used medications for managing cardiovascular conditions such as hypertension and angina. While beta blockers are effective in reducing heart rate and blood pressure, amlodipine helps by dilating blood vessels. This article explores the combined use of these medications and their effects on various cardiovascular outcomes.

Anti-Ischaemic Effects in Coronary Patients

Amlodipine and Beta Blockers in Myocardial Ischaemia

In patients with severe coronary conditions experiencing transient myocardial ischaemia despite beta-blocker therapy, the addition of amlodipine was studied. The results indicated that amlodipine did not significantly reduce the frequency or duration of ambulatory ischaemia compared to placebo. However, there was a trend towards decreased exercise-induced ST segment depression and increased ischaemia-free workload capacity.

Long-Term Efficacy in Stable Angina Pectoris

A study involving patients with stable angina pectoris pre-treated with beta blockers showed that chronic treatment with amlodipine significantly decreased ST segment depression and increased ischaemia-free workload capacity. The number of anginal attacks was also reduced, demonstrating the additional anti-ischaemic and anti-anginal efficacy of amlodipine when combined with beta blockers.

Hypertension Management

Blood Pressure Control and Vascular Effects

Combining amlodipine with beta blockers has shown to be effective in managing hypertension. A study comparing the effects of amlodipine and atenolol on small arteries found that amlodipine improved resistance artery structure and endothelial function, whereas atenolol did not. Another study demonstrated that adding amlodipine to atenolol significantly reduced blood pressure in patients whose hypertension was not controlled by atenolol alone.

Central Systolic and Pulse Pressure Reduction

Beta blockers are less effective in reducing central systolic and pulse pressure due to increased aortic augmentation. However, combining amlodipine with beta blockers eliminates this adverse effect, leading to effective reduction of central systolic blood pressure and pulse pressure.

Cardiovascular Outcomes and Stroke Risk

Comparative Cardiovascular Event Prevention

The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA) compared an amlodipine-based regimen with an atenolol-based regimen. The amlodipine-based regimen was more effective in preventing major cardiovascular events, including stroke, and induced less diabetes compared to the atenolol-based regimen. The study also found that amlodipine reduced blood pressure variability, which partly explained the lower risk of stroke.

Quality of Life and Autonomic Nervous Activity

Health-Related Quality of Life

In patients with poorly controlled hypertension, the combination of amlodipine and the beta blocker betaxolol improved cardiac autonomic nervous activity and health-related quality of life more effectively than increasing the dose of amlodipine alone.

Conclusion

The combination of amlodipine and beta blockers offers several benefits in managing cardiovascular conditions, including improved anti-ischaemic effects, better blood pressure control, reduced central systolic and pulse pressure, and enhanced quality of life. These findings support the use of combined therapy for patients who do not achieve optimal outcomes with beta blockers alone.

Summary

Not a yes or no question

Amlodipine and Beta Blockers: Combined Therapy for Cardiovascular Conditions

Introduction to Amlodipine and Beta Blockers

Anti-Ischaemic Effects in Coronary Patients

Amlodipine and Beta Blockers in Myocardial Ischaemia

Long-Term Efficacy in Stable Angina Pectoris

Hypertension Management

Blood Pressure Control and Vascular Effects

Central Systolic and Pulse Pressure Reduction

Cardiovascular Outcomes and Stroke Risk

Comparative Cardiovascular Event Prevention

Quality of Life and Autonomic Nervous Activity

Health-Related Quality of Life

Conclusion

Sources and full results

Effects of amlodipine on transient myocardial ischaemia in patients with a severe coronary condition treated with a beta-blocker. Amlor-Holter Study Investigators.

Pharmacokinetics and additional anti-ischaemic effectiveness of amlodipine, a once-daily calcium antagonist, during acute and long-term therapy of stable angina pectoris in patients pre-treated with a beta-blocker.

A 6-week double-blind comparison of amlodipine and placebo in patients with stable exertional angina pectoris receiving concomitant beta-blocker therapy.

PP.21.27: COMBINATION WITH AMLODIPINE ELIMINATES ADVERSE EFFECT OF A BETA-BLOCKER ON AORTIC PULSE PRESSURE AUGMENTATION

Amlodipine combined with beta blockade for chronic angina: Results of a multicenter, placebo‐controlled, randomized double‐blind study

Effect of amlodipine compared to atenolol on small arteries of previously untreated essential hypertensive patients.

COMBINATION THERAPY WITH BETA‐ADRENERGIC BLOCKADE AND AMLODIPINE AS SECOND LINE TREATMENT IN ESSENTIAL HYPERTENSION

Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled tri

Effects of β blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke

Comparative effects of amlodipine monotherapy and combination therapy with betaxolol on cardiac autonomic nervous activity and health-related quality of life in patients with poorly controlled hypertension.

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