Antihypertensive effects of nifedipine combined with cardioselective beta-adrenergic receptor antagonism by atenolol.

The calcium-channel blocker, nifedipine, was used as additional oral therapy to beta-adrenergic receptor blockade by the cardioselective agent, atenolol, in the therapy of 31 patients with hypertension. Initial studies were directed towards control of associated angina pectoris in 15 of the patients, but no effects were found on angina except in two patients. However, arterial blood pressure was consistently reduced in all patients. Further studies on 16 patients were therefore directed towards the use of nifedipine as an antihypertensive agent in addition to atenolol and a thiazide diuretic. Nifedipine (10 mg sublingually) acutely dropped blood pressure by about 30/20 mm Hg (systolic/diastolic) within 20 minutes. Follow-up studies made after 4 to 8 weeks showed that the initial acute response to nifedipine predicted the long-term response to oral nifedipine, 10 mg twice daily. Of 31 hypertensive patients tested, only one failed to respond to nifedipine.