NICE-Combi study: Effect of nifedipine in combination with an angiotensin II receptor blocker on BP control and renal protection

Combination of antihypertensive drugs which have different mechanisms of action need to be considered to achieve the goal of therapy recommended in guidelines for the treatment of hypertension. However, there are few data on the most suitable combinations for antihypertensive therapy. The randomised, double-blind NICE-Combi (Nifedipine and Candesartan Combination) study was conducted in hypertensive patients who did not achieve their target blood pressure on monotherapy with an angiotensin II receptor blocker (ARB). It compared the anti hypertensive effect between increasing ARB dosage and the addition of controlled-release nifedipine. Adding once-daily nifedipine to an ARB showed better antihypertensive effect and renal protection than increasing the dosage of the ARB and both treatments had similar tolerability. Compared with monotherapy, combination therapy also reduced the cost of therapy in patients with hypertension.