Optimizing Hypertension Management in Primary Aldosteronism Screening: The Role of Dual Calcium Channel Blockers

Primary aldosteronism (PA) poses a distinct challenge in hypertension management, especially during the drug washout phase before diagnostic screening. This retrospective study evaluated the effectiveness and safety of a dual calcium channel blocker (CCB) regimen--amlodipine combined with verapamil--for blood pressure control during this critical period. We reviewed data from 434 hypertensive patients who underwent secondary hypertension screening at the First Affiliated Hospital of Guangxi Medical University between 2019 and 2025. Compared with the antihypertensive treatments used before the washout phase, the dual CCB approach achieved significant reductions in seated systolic blood pressure (SBP) (163.08 {+/-} 22.28 mmHg vs. 135.16 {+/-} 14.85 mmHg; p < 0.001), diastolic blood pressure (DBP) (99.90 {+/-} 15.96 mmHg vs. 83.38 {+/-} 12.27 mmHg; p < 0.001), and heart rate (HR) (85.29 {+/-} 15.61 bpm vs. 76.14 {+/-} 9.42 bpm; p < 0.001). When comparing patients with PA to those with essential hypertension, there were no significant differences in SBP (132.51{+/-}14.16 vs. 135.41{+/-}14.57 mmHg; p = 0.276), DBP (81.24{+/-}12.12 vs. 82.47{+/-}10.94 mmHg; p = 0.562), or HR (75.71{+/-}7.61 vs. 76.34{+/-}11.17 bpm; p = 0.722). The only adverse event noted was intermittent first-degree atrioventricular block in one patient. In conclusion, the dual CCB regimen proved both effective and well tolerated during the drug washout phase prior to PA screening. These findings highlight a potential strategy for optimizing blood pressure management in this context. Further studies are warranted to confirm its long-term role in clinical practice.