Transdermal clonidine as an adjunct to nifedipine-GITS therapy in patients with mild-to-moderate hypertension.
Calcium channel blockers and central alpha-agonists are among the classes of antihypertensive drugs that yield the most favorable overall effects on risk factors for hypertension-related end-organ damage. An open-label prospective trial in 42 patients with a mean baseline blood pressure of 144/102 mm Hg sought to assess the usefulness of adjunctive treatment with transdermal clonidine (0.1 to 0.3 mg/day) in patients responding inadequately to nifedipine--gastrointestinal therapeutic system (GITS) (30 to 60 mg/day) monotherapy. Thirty-nine patients who failed to reach the goal of a seated mean diastolic blood pressure of < 90 mm Hg when treated only with once-a-day nifedipine-GITS entered a transdermal clonidine (once a week) titration phase followed by an 8-week maintenance course of the two drugs combined. The 35 patients completing this last phase responded with a mean seated diastolic blood pressure of 127/87 mm Hg. Only six patients required the highest dose of clonidine for control. A 97% compliance rate with the transdermal medication contrasted with a compliance rate of only 73% for the oral nifedipine. Two of three patients who had contact dermatitis after wearing a transdermal clonidine patch withdrew from the trial prematurely; other minor side effects required no interruption of therapy. The nifedipine-clonidine combination not only achieved blood pressure control in these patients but may prove advantageous in combining the protective effects of the two agents against complications of the hypertensive syndrome.
Houston
M C
MC
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37205.
Hays
L
L
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D003000:Clonidine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D010349:Patient Compliance; D011446:Prospective Studies; D013997:Time Factors
D009543:Nifedipine; D003000:Clonidine