Nitrendipine: antihypertensive efficacy similar to that of propranolol

The antihypertensive efficacy of the calcium antagonist nitrendipine [Bay-e-5009; Bayer] was evaluated in 25 patients with WHO stage I-II essential hypertension. After withdrawal of other medication, placebo was given bid for 2 weeks before patients were randomised to treatment with either nitrendipine 10mg bid or propranolol 80mg bid. After 4 weeks and a 1-week washout period , treatments were crossed over. Dosages were doubled, if necessary, after 2 weeks to achieve a sitting diastolic BP < 90mm Hg or a reduction of > 10mm Hg.

Significant reductions in BP had occurred with both treatments after 2 weeks (p < 0.001) and by 4 weeks the mean BP in the nitrendipine group had decreased from 171/107 to 147/91mm Hg (p < 0.001) and in the propranolol group to 145/93mm Hg (p < 0.001). BP was normalised in a total of 7 patients on both treatments. Nitrendipine significantly increased the heart rate from 79.6 to 84.6 beats/min while propranolol reduced it to 65 beats/min after 4 weeks. A significant positive correlation was found between the hypotensive effect of nitrendipine and the initial standing plasma noradrenaline [norepinephrine] levels. Nitrendipine's antihypertensive effect also correlated positively and significantly with age. Two nitrendipine patients withdrew because of headache and flushing (2) plus ankle oedema (1). One propranolol patient withdrew because of numb extremities.

It was concluded that nitrendipine and propranolol are of similar efficacy and that nitrendipine may be useful in older patients. Fritschka, E: Distler, A, Gotzen, R., Thiede, H.·M. and Phifipp, T.: Journal of Cardiovascular Pharmacology 6 (Suppl 7): 51100-51104 (1984)

0156-2703/ 85/ 0511 -0005/ 0$01 .00/ 0 © ADIS Press INPHARMA ® 11 May 1985 5