Effects of nifedipine GITS 20 mg or enalapril 20 mg on blood pressure and inflammatory markers in patients with mild-moderate hypertension.
OBJECTIVE
Calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors and other drug classes either alone or in combination have been recommended for the treatment of hypertension. Nifedipine gastrointestinal therapeutic system (GITS) 20 mg is a new low-dose formulation with an improved tolerability. The aim of the present study was to compare the effects of nifedipine GITS 20 mg and enalapril 20 mg on blood pressure and circulating adhesion molecules in hypertensive patients.


METHODS
This randomized, double-blind, multicentre trial compared the blood pressure lowering effects of a 12-week treatment of nifedipine GITS 20 mg vs enalapril 20 mg in 264 patients with mild-to-moderate hypertension.


RESULTS
Nifedipine GITS 20 mg induced a reduction of clinic blood pressure, which was similar to that observed with enalapril 20 mg. Nifedipine GITS and enalapril lowered mean sitting diastolic blood pressure by 11.8 and 12.4 mmHg, respectively, while systolic blood pressure was reduced by 15.3 and 16.3 mmHg, respectively. Ambulatory blood pressure monitoring-derived blood pressure data showed similar results in both groups without any statistically significant differences between treatments. Both enalapril and nifedipine tended to reduce ICAM-1 and E-selectin, while only nifedipine reduced von Willebrand factor. Both treatments were well tolerated.


CONCLUSIONS
Our findings demonstrate a similar antihypertensive effectiveness of a low dose (20 mg) of nifedipine GITS in comparison with a standard dose of enalapril (20 mg). Given its clinical efficacy and good tolerability, low-dose nifedipine GITS may be considered a valuable treatment option for hypertensive patients.
Agabiti Rosei
Enrico
E
Chair of Internal Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy. agabiti@med.unibs.it
Morelli
Patrizia
P
Rizzoni
Damiano
D
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D019040:E-Selectin / Q000096:biosynthesis; D004656:Enalapril / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage* / Q000494:pharmacology*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000494:pharmacology; D014841:von Willebrand Factor / Q000378:metabolism
D000806:Angiotensin-Converting Enzyme Inhibitors; D019040:E-Selectin; D014665:Vasodilator Agents; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D004656:Enalapril; D009543:Nifedipine