A comparison of isradipine and felodipine in Australian patients with hypertension: focus on ankle oedema. The Physician's Study Group.
The aim of this study was to compare the tolerability and efficacy of isradipine and felodipine in the treatment of mild-moderate hypertension. After a 4 week placebo period, 143 patients entered a randomized, double-blind, multicentre study of 12 weeks duration. Patients received either isradipine (n = 72) or felodipine (n = 71) 2.5 mg twice daily. Doubling of this dose and the addition of enalapril (2.5 mg once daily) was permitted if DBP was > 90 mmHg at weeks 4 and 8, respectively. Isradipine monotherapy reduced BP from 165/104 +/- 13/6 mmHg at baseline to 149/91 +/- 14/10 mmHg at week 8 (p < 0.001), while felodipine alone reduced BP from 171/104 +/- 17/6 at baseline to 151/92 +/- 19/9 (p < 0.001). Following the addition of enalapril to 35% of patients in the isradipine group BP was further reduced to 144/88 +/- 13/8 mmHg at week 12 (p < 0.001). The addition of enalapril to 24% of the felodipine group further reduced BP to 150/92 +/- 19/9 mmHg at week 12 (p < 0.001). No differences in BP were found between the 2 groups while on monotherapy. However, the isradipine group had a significantly lower DBP than the felodipine group at the conclusion of the study (p = 0.008; 95% CI 0.7 to 6.9 mmHg). Similar incidences of headache, flushing, dizziness and tachycardia were reported in both groups. However, the incidence of ankle oedema was significantly lower in the isradipine group (p = 0.028). Overall, ankle oedema was reported more often by female patients and was not associated with an increase in weight.(ABSTRACT TRUNCATED AT 250 WORDS)
Hammond
J J
JJ
Melbourne Hypertension Clinic, Vic., Australia.
Cutler
S A
SA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000842:Ankle; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004361:Drug Tolerance; D004487:Edema / Q000139:chemically induced*; D004656:Enalapril / Q000008:administration & dosage; D015736:Felodipine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D017275:Isradipine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged
D008055:Lipids; D004656:Enalapril; D015736:Felodipine; D017275:Isradipine