Oral Nifedipine and Atenolol Are Comparable Agents As initial treatment of malignant hypertension in Black patients

In a single- (n = 10) and double-blind (n = 10) trial, 20 Black patients with malignant hypertension (WHO criteria) were hospitalised and randomised to treatment with slow release nifedipine 40mg bid or atenolol 100mg once daily for 1 day.

In the nifedipine group, mean supine BP was 233/142mm Hg at baseline and reached a minimum of 166/ 100mm Hg 5 hours after the first dose and 157/94mm Hg 4 hours after the second dose. In the atenolol­treated patients, BP fell from 226/141mm Hg to a minimum of 162/100mm Hg 16 hours after the dose. The reduction in BP was the same with both drugs but the rate of fall was greater with nifedipine. Heart rate was increased after nifedipine and decreased after atenolol. No patient developed focal neurological signs or heart failure during hospitalisation but a pre-existing headache worsened in 2 nifedipine-treated patients. Thus, oral atenolol and nifedipine are equally effective as initial therapy of malignant hypertension in Black patients. Isles CG Johnson AOe Milne FJ Bnflsh Journal 01 Clinical Pharmacology 21. 377·383. Apr 1986

0156-2703/86/0712.()()11/0S01.00/0 © ADIS Press INPHARMA'" 12 July 1986 11