Comparison of nitrendipine combined with low-dose hydrochlorothiazide to hydrochlorothiazide alone in mild to moderate essential hypertension.
Patients with mild to moderate essential hypertension were treated in four centers with hydrochlorothiazide (HCTZ) 25 mg daily for 4 weeks. Those patients failing to achieve control (supine diastolic blood pressure (DBP) 90 mm Hg or lower) were randomly assigned to nitrendipine (NTP) 5 mg or placebo (PLA) b.i.d. NTP or PLA was increased stepwise to 20 mg b.i.d. as needed to achieve control. Treatment with HCTZ was maintained at 25 mg daily. Eighty-six patients completed the study: 41 in NTP + HCTZ and 45 in PLA + HCTZ groups. Both groups were comparable in baseline characteristics. Supine systolic blood pressure (SBP) was 148.6 +/- 14.4 and DBP was 96.0 +/- 5.4 mm Hg in the NTP + HCTZ group. SBP was 147.4 +/- 16.6 and DBP was 96.4 +/- 5.6 mm Hg in the PLA + HCTZ group. At the end of 7 weeks of titration and treatment with NTP or PLA combined with HCTZ, SBP had fallen to 133.4 +/- 15.1 and DBP to 85.4 +/- 5.9 mm Hg in the NTP + HCTZ group. SBP fell to 138.8 +/- 16.2 and DBP to 90.7 +/- 6.3 mm Hg in the PLA + HCTZ group. The increment in lowering of both SBP and DBP was significantly greater (p = 0.002 and p = 0.0007, respectively) in the NTP + HCTZ group compared to the PLA + HCTZ group.
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009568:Nitrendipine; D011897:Random Allocation; D013997:Time Factors
D002121:Calcium Channel Blockers; D006852:Hydrochlorothiazide; D009568:Nitrendipine; D009543:Nifedipine