Nifedipine/ Atenolol Appears More Effective than Monotherapy In contrOlling BP in patients with essential hypertension

A double-blind trial was conducted to evaluate the efficacy and tolerability of short term treatment with nifedipine and atenolol, given alone and in fixed combination in patients with hypertension.

81 patients from 6 centres with mild to moderate essential hypertension (sitting diastolic BP 100-120mm Hg) randomly received slow release nifedipine 20mq bid, atenolol 50mg in the morninq and placebo in the evening or slow release nifedipine 20mg + atenolol 50mg in the morning and ' placebo in the evening. Each schedule was followed for 4 weeks before crossing over to alternate regimens .

All 3 treatments lowered both supine and standing BPs from pretreatment values . The combination regimen reduced supine and standing systolic (p < 0.01 and p < 0.001, respectively) and diastolic (p < 0.001) BP compared with nifedipine alone , and it also reduced supine and standing systolic (p < 0.01 and p < 0.03, respectively) and diastolic (p < 001) BP compared with atenolol alone. Atenolol alone or in combination with nifedipine reduced supine (p < 0.00 1) and standing (p < 0.00 1) heart rate compared with nifedipine alone.

Nine patients withdrew because of adverse effec ts w hile receiving nifedipine alone, 2 during atenolol monotherapy and 4 during combination therapy. The most prevalent side effects consisted of flushes and hot sweats which occurred less frequently ( p < 0.01) with atenolol and combination treatments than nifedipine alone.

The combination of nifedipine/atenolol lowered BP further than either drug given alone and therefore " __ for selected hypertensive patients a regimen of the lowest dose of atenolol and nifedipine given once daily may be appropriate for those not responding to either treatment separately', I\nde" ()~ JL Vallance 80 Slanlpy N\J e ro,·.e P F M,l l ra B . el al Drugs 35 (SUppl 4) 22·26. 1988

0156-2703/ 88/ 0476·0013/ 0S07 .00/ 0 © ADIS Press INPHARMA' 16 April 7988 13