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β-Blockers and Calcium Antagonists

Cornerstones of Antihypertensive Therapy in the 1980s

  • Section 1B: Hypertension
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Summary

The majority of physicians have now adopted β- blockers as alternative first- line anti- hypertensive drugs mainly because of their good efficacy/tolerability ratio. Where mono- therapy proves to be unsatisfactory, blood pressure control is achieved in most other patients by adding a diuretic, especially in older patients with low renin. β- Blocker- based antihypertensive therapy has gained an additional attraction because of studies showing that it can reduce the risk of sudden death and reinfarction (secondary prevention).

Almost in parallel to β- blockers, calcium antagonists were introduced for angina pectoris and tentatively used for the treatment of high blood pressure, but their place in antihypertensive treatment has yet to be established. The antihypertensive efficacy of the calcium influx inhibitor, verapamil (in a new sustained- release formulation), was tested in 43 patients and compared intraindividually with the long term effects of a β- blocker or diuretic therapy. The results of this study provide a basis for a new antihypertensive treatment concept, proposing verapamil (or other calcium antagonists) as a first- line drug for older and low renin patients as an alternative to diuretics, and a β- blocker for younger and high renin patients.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine and Department of Research, University Hospital, 4031, Basel, Switzerland

    F. R. Bühler, U. L. Hulthén, W. Kiowski & P. Bolli

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  1. F. R. Bühler
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  2. U. L. Hulthén
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  3. W. Kiowski
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  4. P. Bolli
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Bühler, F.R., Hulthén, U.L., Kiowski, W. et al. β-Blockers and Calcium Antagonists. Drugs 25 (Suppl 2), 50–57 (1983). https://doi.org/10.2165/00003495-198300252-00010

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