Effects of a combination of atenolol and nifedipine on ambulatory and office blood pressure and heart rate

Abstract Beta-blockers and vasodilators both reduce blood pressure (BP) but have opposite effects on the adrenergic and renin-angiotensin systems. A low-dose combination of these two classes of drugs might control high blood pressure without affecting the adrenergic and hormonal status of the patients. In a double-blind study, we investigated the effects of a once-daily dose of atenolol 50 mg plus slow-release nifedipine 20 mg. Patients with diastolic blood pressures between 90 and 110 mmHg received either atenolol plus nifedipine (A + N) (n = 31) or placebo (n = 26). Ambulatory 24-hour BP and heart rate were measured before and 1 month after treatment. The effects of the drugs were assessed at four different periods of the day. After 1 month of treatment, ambulatory ABP was significantly lower in the A + N group, compared with the placebo group, throughout the day ( P = 0.03 to P P