SUCCESSFUL MANAGEMENT OF REFRACTORY HYPERTENSION WITH DUAL CALCIUM-CHANNEL BLOCKER THERAPY - CASE PRESENTATION

Dual calcium channel blocker therapy seems to be safe and effective fo r the treatment of refractory hypertension. Nondihydropyridine calcium channel blockers (verapamil and diltiazem hydrochloride) exert their antihypertensive effects by decreasing cardiac output via negative ino tropic and negative chronotropic activity and by peripheral vasodilati on. Dihydropyridine calcium channel blockers exert their antihypertens ive effects via potent peripheral vasodilation. Based on the above pro perties, synergistic lowering of blood pressure is possible with combi ned nondihydropyridine plus dihydropyridine calcium channel blocker th erapy. The adverse effect profile of dual calcium channel blocker ther apy is attractive due to the lack of effect on cholesterol and blood g lucose levels, mood, exercise tolerance, and sexual function reported with many of the available antihypertensive options.