NISOLDIPINE CC AND LISINOPRIL ALONE OR IN COMBINATION FOR TREATMENT OF MILD-TO-MODERATE SYSTEMIC HYPERTENSION

The efficacy and safety of nisoldipine CC and lisinopril were compared in 278 patients with mild to moderate systemic hypertension in a doub le-blind, placebo run-in trial. Patients were randomized to nisoldipin e CC or lisinopril for 8 weeks to achieve a trough sitting diastolic b lood pressure (BP) less than or equal to 90 mmHg. Responders were main tained on their optimal dose for a further 8 weeks. Nonresponders were switched to combination therapy and treated for 8 weeks. Twenty-four- hour ambulatory BP monitoring (ABPM) was carried out during placebo an d monotherapy. The responder rate of 73.8% with nisoldipine CC after 8 weeks was greater than 56.1% with lisinopril (p = 0.007). The respond er rate with combination therapy was 61%. ABPM showed that both nisold ipine CC and lisinopril produced constant blood pressure lowering effe cts over the 24-hour period and maintained circadian rhythm. Adverse e ffects were more frequent with nisoldipine CC (headache and peripheral edema) than with lisinopril (cough) monotherapy. Nisoldipine CC monot herapy was at least as effective as lisinopril monotherapy in the mana gement of mild to moderate hypertension. Both agents were well tolerat ed. Combination therapy with nisoldipine CC and lisinopril was effecti ve and well tolerated in patients with blood pressure not controlled b y monotherapy alone.