EFFECT OF NITRENDIPINE THERAPY ON CASUAL AND 24-HOUR AMBULATORY BLOOD-PRESSURE IN MILD TO MODERATE HYPERTENSION

A study was conducted to evaluate the short- and long-term effectiveness and tolerability of nitrendipine once daily in patients with mild to moderate hypertension. Twenty-two hypertensive patients with supine diastolic blood pressures between 95 and 115 mmHg were enrolled. The patients were given 20 mg of nitrendipine once daily. If the blood pressure was not normalized (supine diastolic blood pressure <90 mmHg) after 2 months, they were given 20 mg of the drug twice daily. The patients were followed up at periodic visits for 6 months. Seven of the 22 patients underwent ambulatory blood pressure monitoring. At the beginning and end of the study, a laboratory evaluation was performed. Nitrendipine decreased mean +/- SD supine and standing blood pressure from 165.2 +/- 18.9/102.0 +/- 4.0 mmHg to 143.6 +/- 15.7/87.0 +/- 7.0 mmHg and from 160.7 +/- 19.0/103.1 +/- 5.8 mmHg to 139.1 +/- 16.9/89.3 +/- 6.0 mmHg, respectively (P < 0.0001). Supine diastolic blood pressure was normalized in 81.8% of the patients. The drug did not induce significant changes in heart rate. The 24-hour measurements showed a mean decrease in diastolic blood pressure from 93.5 +/- 6.4 mmHg to 85.6 +/- 4.3 mmHg (P < 0.01) and in systolic blood pressure from 133.4 +/- 5.6 mmHg to 123.8 +/- 12.4 mmHg. No significant changes in laboratory tests were observed. Flushing and headache were the most frequent side effects. Nitrendipine significantly reduces blood pressure in mild to moderate hypertensive patients with minimal side effects.