Efficacy of nifedipine as a step 3 antihypertensive drug.
The efficacy of nifedipine (N) as a "step 3" antihypertensive drug was assessed in 15 patients who remained hypertensive in spite of atenolol 100 mg and bendrofluazide 5 mg daily. Nifedipine was added in doses of 10, 20, and 30 mg three times daily in a placebo-controlled double-blind trial. Supine mean blood pressure was reduced by 11.9% +/- 6.2% by N 10 mg three times daily, by 13.9% +/- 7.6% by N 20 mg three times daily and by 20.3% +/- 6.2% by N 30 mg three times daily. Plasma potassium was reduced from 3.9 +/- 0.5 mEq/liter on placebo to 3.6 +/- 0.5 mEq/liter on N 10 mg three times daily, 3.6 +/- 0.4 mEq/liter on N 20 mg three times daily (p less than 0.05), and 3.5 +/- 0.5 mEq/liter on N 30 mg three times daily (p less than 0.05). Heart rate, body weight, renal function, and plasma glucose were not altered. Nifedipine is thus a useful third-line hypotensive agent that should be used in combination with a potassium-sparing diuretic.
D000328:Adult; D001262:Atenolol / Q000008:administration & dosage*; D001539:Bendroflumethiazide / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage* / Q000009:adverse effects; D011412:Propanolamines / Q000008:administration & dosage*; D011725:Pyridines / Q000008:administration & dosage*
D011412:Propanolamines; D011725:Pyridines; D001262:Atenolol; D001539:Bendroflumethiazide; D009543:Nifedipine