Antihypertensive effectiveness of nifedipine gastrointestinal therapeutic system in the elderly. The Modern Approach to the Treatment of Hypertension (MATH) Study Group.
The Modern Approach to the Treatment of Hypertension (MATH) trial was conducted to determine the therapeutic safety and efficacy of the once-a-day nifedipine gastrointestinal therapeutic system (GITS) formulation in a large and diverse cohort of patients with mild-to-moderate hypertension. One of the goals of the MATH study was to evaluate the clinical utility of nifedipine GITS in elderly hypertensives. This analysis compares the safety and efficacy of nifedipine GITS in elderly patients (greater than or equal to 65 years of age) and nonelderly patients (adults less than 65 years of age). A total of 222 elderly and 933 nonelderly patients from 127 centers were evaluated. Following a 2 week placebo washout phase, patients were titrated over 1 to 6 weeks on nifedipine GITS 30 to 180 mg/day, increasing in 30 mg increments to achieve goal blood pressure, defined as sitting diastolic blood pressure of less than 90 mm Hg and a 10 mm Hg decrease from baseline. Therapy was maintained at the optimal dose for an additional 12 weeks. Hemodynamic and laboratory parameters were assessed at baseline and at the final treatment visit. Baseline parameters were comparable between patient groups except for systolic blood pressure, which was significantly greater in the elderly compared with nonelderly patients (164 +/- 18 v 150 +/- 14 mm Hg, respectively, P less than .0001). After 12 weeks of therapy with nifedipine GITS, sitting and standing systolic and diastolic blood pressure was significantly decreased from baseline for both elderly and nonelderly patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Bravo
E L
EL
Endocrine/Hypertension Research Laboratory, Cleveland Clinic, Ohio 44106.
Krakoff
L R
LR
Tuck
M L
ML
Friedman
C P
CP
D000368:Aged; D000375:Aging / Q000502:physiology*; D001794:Blood Pressure / Q000187:drug effects; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D004573:Electrolytes / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D004573:Electrolytes; D008055:Lipids; D009543:Nifedipine