Interactions between drugs and antihypertensive agents can result in either increased or decreased antihypertensive effects. These interactions may be pharmacokinetic or pharmacodynamic in type, resulting in either altered plasma drug concentrations or altered drug effects at similar plasma concentrations. Drugs may limit the absorption of antihypertensive agents, alter their metabolism through...

Adverse drug-drug interactions may occur when a major therapeutic mechanism of one drug class (such as bradycardia with a beta blocker) is excessively exaggerated by the addition of another heart-rate slowing antihypertensive, such as verapamil. The most important interactions at the molecular level are those of the hepatic enzyme, cytochrome (CYP) 3A4. A classic example is the inhibitory effec...

Pulse Pressure and Antihypertensive Agents To the Editor: In their subanalysis of the LIFE study,1 the authors conclude that they “show superior protection against stroke in patients treated with losartan when compared with atenolol . . . This difference may be related to specific effects of angiotensin type 1 receptor antagonism . . . beyond blood BP reduction.” The authors do not consider the...