Nitrendipine and atenolol in essential hypertension in young and middle-aged patients: effect on serum lipids and left ventricular mass.
This study was designed to compare the antihypertensive efficacy of nitrendipine and atenolol in young and middle-aged patients with mild or moderate essential hypertension and to assess treatment effects on plasma lipids and potential changes in left ventricular mass (LVM). After 2 weeks off medication and a 4-week placebo phase, patients who met the inclusion criteria [sitting diastolic blood pressure (DBP) 95 to 114 mm Hg, age below 50 years] entered a 12-week dose-adjustment and maintenance period with nitrendipine or atenolol. Serum lipids were determined before and after therapy. At the same time, LVM was evaluated echocardiographically (M mode). Twenty-two patients completed the double-blind, randomized study. After 12 weeks on nitrendipine, the systolic blood pressure (SBP) and DBP were reduced (p less than 0.005 and p less than 0.001, respectively). No significant changes in heart rate were observed. There were no changes in the lipid profile, and LVM was reduced from 93.7 to 23.4 to 82.4 +/- 22.6 g/m2 of body surface (p less than 0.05). On atenolol the SBP and DBP were reduced (p less than 0.001 and p less than 0.001, respectively). The expected reduction in heart rate was significant (p less than 0.05). Total cholesterol and LDL cholesterol increased by 11% (p less than 0.05) and 12.3% (p less than 0.01), respectively. HDL cholesterol showed a small reduction. Tryglycerides increased by 22% (n.s.). LVM did not change. In conclusion, nitrendipine and atenolol showed comparable antihypertensive efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
López
N C
NC
Unidad de Hipertensión Arterial, Hospital Central de Maracay, Venezuela.
Corral
J L
JL
Rincón
L A
LA
Arreaza
M R
MR
Giralt
J
J
Galué
G A
GA
Barrios
Y E
YE
Arocha
I
I
D000328:Adult; D001262:Atenolol / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006352:Heart Ventricles / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000009:adverse effects / Q000627:therapeutic use*
D008055:Lipids; D001262:Atenolol; D009568:Nitrendipine