Therapy Atenolol/Nifedipine Is Superior to Atenolol Monotherapy In reducing BP in patients with mild hypertension

A double-blind crossover study assessed the antihypertensive efficacy, at rest and during exercise, of atenolol alone and in combination with nifedipine in the treatment of patients with mild hypertension. 30 patients with previously untreated WHO stage I-II hypertension received atenolol 50mg daily for 4 weeks after a 14-day drug-free run-in. Atenolol 50mg/nifedipine 20mg (sustained release) and atenolol 100mg were then given for 4 weeks each.

Two hours after drug administration , BP at rest and during bicycle ergometry was significantly (p < 0.001) reduced by atenolol 50 and combination therapy. Resting BP was reduced (p < 0.01) after doubling the atenolol dosage and further reduced (p < 0.01) by combination therapy. During exercise, there was no significant difference in BP between the 2 doses of atenolol but combination therapy reduced BP (p < 0.05/p < 0.001) more than atenolol 50mg. 24 hours after drug administration, all 3 drug therapies reduced resting BP. Increases in BP induced by cold pressor and isometric tests were significantly (p < 0.001) reduced by the 3 treatments; the least effect was seen with atenolol 50mg and the greatest with combination therapy . Adverse reactions were mostly mild and occurred predominantly during the first 14 days of each treatment. Cold hands and feet occurred in 8 patients during atenolol 50mg, 7 during atenolol 100mg and 2 during combination therapy. After 8.4 months of atenolol/ nifedipine treatment, left ventricular mass was significantly reduced by 22% and septum, posterior and relative wall thicknesses were also reduced.

Thus, adding nifedipine 20mg to atenolol 50mg appears to be more effective than doubling the dosage of atenolol in reducing BP at rest and during stress and is well tolerated in patients with mild hypertension. Franz I-W. Ketelhut A. Behr U, Tonnesmann U. Medizinische Welt 38: 1270-1276,24 Sep 1987 [Translated from the original article published in

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