Efficacy and tolerability of atenolol, nifedipine and their combination in the management of hypertension.

This randomised, double-blind, crossover study investigated the haemodynamic effects of a beta-blocker (atenolol 50mg) and a calcium antagonist (sustained release nifedipine 20mg) given either separately or in combination in 3 groups of patients with mild to moderate essential hypertension. Each treatment was administered twice daily. The fixed combination given twice daily for 4 weeks produced reductions in blood pressure which lasted for at least 12 hours after administration of the final dose. The control of blood pressure by the combination was superior to that achieved by its individual components. Side effects normally associated with nifedipine therapy were less frequent when it was administered with atenolol. Compliance with treatment was good, but it was best when the drugs were given together rather than separately. A fixed combination of atenolol and nifedipine may prove useful in treating hypertensive patients inadequately controlled on beta-blocker therapy alone.