Nitrendipine Brings Down Blood Pressure It has similar antihypertensive efficacy to propranolol ...

In a double-blind, randomized multicentre trial the antihypertensive efficacy of nitrendipine was compared with that of propranolol. After a 2-week washout and a 2-week placebo run-in, patients randomly received either nitrendipine 5-20mg bid (n = 149) or propranolol 40-120mg bid (n = 151). Dosages were titrated during the first 4 weeks until the sitting diastolic BP was < 95mm Hg. Maintenance therapy was continued for 12 weeks.

Both treatments significantly reduced mean BP after 4, 8 and 12 weeks of maintenance therapy, but nitrendipine produced greater reductions than propranolol (p < 0.05). Ambulatory BP monitoring at 1 centre (n = 23) showed significant reductions in mean 24 hour BP in both groups. Adverse effects were reported by 47% of nitrendipine recipients and 54% of propranolol recipients, necessitating withdrawal of 9 and 12 patients, respectively.

Thus, '_. _ nltrendlplne therapy reduced BP as effectively as the beta blocker propranolol'. Zachariah PK. European Heart Journal 8 (Suppl. K): 63·67, Nov 1987

... but a twice-daily regimen is necessary to control systolic and diastolic BP in the elderly The antihypertensive effects of once- and twice-daily regimens of nitrendipine were compared in

elderly patients with mild to moderate essential hypertension. After a 2-week placebo run-in, 22 patients aged 65,84 years with standing systolic BP > 170mm Hg and diastolic BP < 1 00-130mm Hg randomly received nitrendipine 10mg once (n = 11) or twice (11) daily in double-blind fashion. The dosage was doubled after 3 weeks if systolic BP was ~ 170mm Hg and diastolic BP ~ 100mm Hg (6 once-daily and 3 bid recipients) and maintenance therapy was given for 6 weeks.

Mean standing BP was reduced by once-daily (not significantjp < 0.05) and bid (p < 0.005/p < 0,001) treatment after 3 weeks of therapy. Mean sitting BP decreased from 189/112 to 172/99mm Hg after 6 weeks of once-daily treatment (n = 6) and from 189/112 to 164/93mm Hg after 6 weeks of bid treatment (n = 8). Standing BP fell from 186/111 to 172/98mm Hg in the 6 patients who received once-daily treatment, and from 184/108 to 162/93mm Hg in the 8 patients who received bid treatment (not significant between regimens).

Thus, nitrendipine 'satisfactorily' controlled diastolic BP when administered once or twice daily in elderly hypertensive patients. However, systolic BP was controlled only by a bid regimen. Pandita·Gunawardena ND. Macdonald G. European Heart Journal 8 (Suppl K) 57·62. Nov 1987

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