Background Combined use of antihypertensives can result
in more effective blood pressure lowering achieved
with smaller doses and is associated with reduced risk of
dose related adverse events. Apart from fixed combinations
of ACE inhibitors or angiotensin receptor blockers
with diuretics or calcium channel antagonists there are
also available combinations of beta-blockers and calcium
channel antagonists of well documented clinical
benefits.
Based on BETAMLO national registry we aimed to
evaluate the clinical characteristics of patients treated
with both beta-blockers and calcium channel antagonists
as well as to focus more on combined pharmacotherapy.

Material and methods National BETAMLO registry was
conducted from April to June 2011 and focused on „real
world” clinical management of hypertensive patients with
concomitant objectively confirmed ischemic heart disease.
A specially designed questionnaire was used to collect data
on: patients demographics, cardiovascular risk factors including
lifestyle, risks’ stratification used for both hypertension
and ischemic heart disease and current drugs used.
A study was fully anonymous and non-interventional.

Results A total number of 677 physicians participated in
BETAMLO registry and reported on 13 541 patients, including
6343 (46.8%) treated with both beta-blockers and
calcium antagonists; females represented 46.6% of patients;
mean age: 66.4 yrs for females and 63.7 yrs for males. Combination
therapy with beta-blockers and calcium channel
antagonists were more common in ischemic heart disease
and hypertensive patients and concomitant renal failure
and diabetes. However more common use of combined
therapy was not associated with better blood pressure or
heart rate control. The most prevalent daily dose of
amlodipide was 5 mg while for beta-blockers 5, 50, 12.5 and 5 mg for bisoprolol, metoprolol, carvedilol and
nebivolol, respectively. The highest demand for combined
preparation was noted for bisoprolol/amlodipine (doses:
5/5, 10/10 and 5/10 mg), metoprolol/amlodipine (doses:
50/5, 100/5, 50/10 and 100/10, 75/5 and 75/10 mg),
carvedilol/amlodipine (doses: 12.5/5, 25/5, 25/10 and
12.5/10 mg) and nebivolol/amlodipine (doses: 5/5, 5/10
and 2.5/5 mg).

Conclusions In Polish patients with concomitant hypertension
and ischemic heart disease the combined therapy
with beta-blockers and calcium channel antagonists is very
popular and justifies introduction of fixed dose combine
preparations; the highest demand can be expected for fixed
dose of amlodipine 5 mg and bisoprolol 5 mg.