title: Multicenter comparison of the nifedipine gastrointestinal therapeutic system and long-acting propranolol in patients with mild to moderate systemic hypertension receiving diuretics. A preliminary experience.
abstract: The efficacy and safety of nifedipine in a gastrointestinal therapeutic system (GITS) push-pull osmotic pump formulation was compared with long-acting propranolol in 49 patients with mild to moderate hypertension already receiving diuretics. Using a two-week placebo run-in, double-blind study design, patients were randomly assigned to receive nifedipine GITS (n = 24) in doses of 30 mg, 60 mg, or 90 mg once daily; or long-acting propranolol (n = 25) in doses of 80, 160, or 240 mg once daily. Previous diuretic therapy was continued. Sitting and five-minute standing blood pressure and heart rate measurements were made 24 hours after dosing. At the endpoint of treatment, both nifedipine GITS and sustained-release propranolol reduced blood pressure compared with placebo (p less than 0.001) in the sitting and standing positions. Nifedipine GITS was more effective in lowering standing systolic blood pressure than was propranolol (p less than 0.02). Propranolol caused a greater reduction in resting heart rate than did nifedipine GITS (p less than 0.003). Both drugs were well tolerated. Nifedipine GITS is an effective and safe once-daily drug for use in patients with hypertension who are already receiving diuretics, may be more effective than sustained-release propranolol, and may be better tolerated than conventional nifedipine capsules.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461.
authors.forename: W H
authors.initials: WH
authors.lastname: Frishman
authors.forename: J L
authors.initials: JL
authors.lastname: Garofalo
authors.forename: A
authors.initials: A
authors.lastname: Rothschild
authors.forename: M
authors.initials: M
authors.lastname: Rothschild
authors.forename: S M
authors.initials: SM
authors.lastname: Greenberg
authors.forename: J
authors.initials: J
authors.lastname: Soberman
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D003692:Delayed-Action Preparations; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009543:Nifedipine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011433:Propranolol / Q000008:administration & dosage*; D011897:Random Allocation; D013607:Tablets
chemical_list: D003692:Delayed-Action Preparations; D004232:Diuretics; D013607:Tablets; D011433:Propranolol; D009543:Nifedipine