title: Felodipine as an alternative to more expensive calcium antagonists in mild to moderate hypertension.
abstract: We studied the therapeutic substitution of a less expensive but equally effective antihypertensive agent and assessed patient outcome. The medication of 39 patients with hypertension was changed from once-daily diltiazem hydrochloride (Cardizem CD) or nifedipine (Procardia XL) to felodipine (Plendil). Titration to a final dose was based on home and office blood pressure measurements assessed over subsequent follow-up clinic visits. Self-administered questionnaires measured different aspects of well-being and symptoms before and after the change in medication. Eighty percent of the cohort switched successfully to felodipine. Office systolic and diastolic pressures improved after the medication change (systolic: 150 mm Hg versus 144 mm Hg; diastolic: 92 mm Hg versus 87 mm Hg). No statistically significant differences were found among the 39 symptoms measured. A yearly savings potential for our institution was estimated to be $72,000.
authors.affiliation: Department of Medicine, Madigan Army Medical Center, Tacoma, Washington, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Landry
authors.forename: J D
authors.initials: JD
authors.lastname: Horwhat
authors.forename: D
authors.initials: D
authors.lastname: Tomich
authors.forename: L
authors.initials: L
authors.lastname: Pinski
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000191:economics / Q000627:therapeutic use*; D004110:Diltiazem / Q000627:therapeutic use; D016527:Drug Costs; D015736:Felodipine / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004110:Diltiazem; D009543:Nifedipine; D015736:Felodipine