A randomised double-blind study comparing nifedipine GITS 20 mg and bendrofluazide 2.5 mg administered once daily in mild-to-moderate hypertension

Abstract

A multicentre, randomised, double-blind, parallel group comparison of nifedipine GITS 20 mg (Adalat ® LA) once daily and bendrofluazide 2.5 mg once daily in patients with mild-to-moderate hypertension was conducted. Two hundred patients with a diastolic blood pressure (BP) in the range 95 to 109 mm Hg were randomised to active treatment for 6 weeks. For the per-protocol efficacy population, both treatments resulted in clinically significant mean reductions of trough diastolic BP (nifedipine GITS −8.9 mm Hg, bendrofluazide −7.9 mm Hg) and systolic BP (nifedipine GITS −10.4 mm Hg, bendrofluazide −10.5 mm Hg). The study demonstrated that nifedipine GITS was 'at least equivalent' to bendrofluazide in the reduction of trough diastolic BP (onesided upper 95% confidence limit, 0.5 mm Hg), where inequivalence had been pre-defined as a difference in

Considerations for Drug Therapy in Hypertension

“…However, much of this evidence is derived from studies in which CCBs were inappropriately prescribed and patients were inadequately monitored 21,22 . There is substantial evidence and there are ongoing studies to support the use of the long‐acting DHP CCBs, such as amlodipine, in a wide spectrum of hypertensive patients 23–28 …”

“…β‐blockers and diuretics are associated with metabolic effects that may offset the benefits of blood pressure reduction. These drugs may also have adverse effects on insulin resistance, contributing to the risk of developing diabetes 20–34 . In comparison, CCBs and ACE inhibitors are generally associated with neutral metabolic effects, although some studies have reported improvements in insulin sensitivity with ACE inhibitors 35–37 .…”