Combined Use of Angiotensin Receptor Blockers and Calcium Channel Blockers in High-risk Hypertensive Populations: An Observational Study

Summary

This protocol evaluates the effects of ARB-CCB combination in high-risk hypertensive patients, comparing it with monotherapy to assess improvements in blood pressure control, vascular and cardiac function, and cardiovascular outcomes.

Abstract

This observational matched cohort study evaluated the combined use of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) in high-risk hypertensive patients to optimize treatment strategies. A total of 330 high-risk hypertensive patients treated between 2018 and 2024 were identified from the cardiovascular department database. Propensity score matching was applied to balance baseline characteristics, yielding three matched groups (n = 110 each): ARB monotherapy (valsartan 80 mg once daily), CCB monotherapy (amlodipine 5 mg once daily), and combination therapy (valsartan/amlodipine 80/5 mg once daily). Data were collected through medical record review, ambulatory blood pressure monitoring, vascular and cardiac ultrasound, electrocardiography, pulse wave velocity measurement, and SF-36 questionnaires. Primary outcomes were cardiovascular and cerebrovascular events and blood pressure control; secondary outcomes included vascular function, cardiac performance, arterial elasticity, and quality of life. All procedures followed standardized protocols, and adverse events were systematically recorded. The findings suggest that the combination therapy was associated with advantages in blood pressure control and vascular outcomes, though further prospective studies are warranted to confirm these observations.

Introduction

Hypertension refers to a state where blood exerts persistently higher-than-normal pressure on blood vessel walls during circulation. In 2023, the European Society of Hypertension issued its 2023 guidelines for managing arterial hypertension, which define hypertension as an office blood pressure reading of ≥140/90 mmHg¹. The European Society of Hypertension Guidelines for Arterial Hypertension define hypertension in a manner that aligns with international standards set by organizations such as the World Health Organization and the European Society of Cardiology, based on existing evidence^2,

Protocol

This study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Taixing People's Hospital Affiliated to Yangzhou University. All data used were de-identified and accessed from a secure, encrypted database. The study was retrospective in nature and did not involve any additional interventions or direct patient contact; thus, informed consent was waived by the ethics committee. The detailed study flowchart is shown in Figure 1.

Patient selection and grouping

Results

Table 1 shows that there were no statistically significant differences in the baseline characteristics among the three groups regarding gender, age, body mass index (BMI), lipid profile indicators [triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], fasting blood glucose (FBG), serum creatinine (CREA), blood urea nitrogen (BUN), and uric acid (UA) levels (P > 0.05). This indicates that the basic characteristic.......

Discussion

In the clinical practice of cardiovascular disease prevention and treatment, hypertension management has consistently been a core component. In high-risk patients with conditions like diabetes, chronic kidney disease, or organ damage, blood pressure control directly affects cardiovascular and cerebrovascular risks and overall prognosis. This study explores the combined effects of ARBs and CCBs in high-risk hypertensive patients using a observational matched cohort study design. The aim is to provide a robust basis for op.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Ambulatory Blood Pressure Monitor	I.E.M. GmbH, Germany	Mobil-O-Graph NG
Automated Arteriosclerosis Detection Device	Omron Healthcare Co., Ltd., Japan	BP-203RPE III
Cardiac Function Analyzer	Nihon Kohden Corporation, Japan	CardioFax ECG-2150
Color Doppler Ultrasound Diagnostic System	Philips Healthcare, USA	EPIQ 7
G*Power	Heinrich Heine University Düsseldorf, Germany	Version 3.1.9.7
Levamlodipine Besylate Tablets (5 mg)	Zhejiang Anglikang Pharmaceutical Co., Ltd.	H20083459
SPSS Statistics	IBM Corp., USA	Version 25.0
Valsartan and Amlodipine Tablets (80/5 mg)	Beijing Novartis Pharma Co., Ltd.	J20150135
Valsartan Capsules (80 mg)	Beijing Novartis Pharma Co., Ltd.	H20040217