[Evaluation of hypotensive and antiischemic effects of a combination of dihydropyridine and non-dihydropyridine calcium antagonists in patients suffering from coronary artery disease with arterial hypertension].

The hypotensive and antiischemic activity of combined therapy with dihydropyridine group (amlodipine) and non-dihydropyridine group (verapamil retard) calcium antagonists (CA) as well as tolerance to this therapy were studied in 43 patients suffering from coronary heart disease (CAD) with II-III functional class exertional angina and II degree essential hypertension during 24 weeks. Twenty-four-hour ECG and blood pressure (BP) monitoring and Doppler EchoCG were done. The combination of amlodipine and verapamil retard in different day doses made it possible to achieve target BP levels in 86% of cases, improved circadian BP pattern and decreased left ventricular myocardial mass index (18.5% on the average; p < 0.01). The study also demonstrated prominent antiischemic and antianginal effects of the therapy, including patients with left ventricular hypertrophy. A decrease in myocardial ischemic (both painful and painless) episode frequency and the total duration of ST segment depression were the most pronounced changes. The combination of amlodipine and verapamil retard had a substantially lower rate of adverse effects compared with that of each of the component when used separately thanks to mutual neutralization of their side-effects or a possibility to lower their doses. Thus, the combination of CA from different groups possesses high hypotensive and antiischemic activity and good tolerance, which allows recommending it for treatment of patients suffering from CAD with arterial hypertension.