AMLODIPINE VERSUS NIFEDIPINE IN THE TREATMENT OF MILD-TO-MODERATE HYPERTENSION IN BLACK-AFRICANS

This single-blind, parallel-group, randomized trial compared the effic acy and tolerability of amlodipine with sustained-release nifedipine i n 45 black African patients between the ages of 29 and 65 years. Amlod ipine and nifedipine were administered after a 2-week washout period a t a dose of 5 mg once daily and 20 mg twice daily, respectively. Dose was increased to 10 mg once daily for amlodipine and 40 mg twice daily for nifedipine in patients with diastolic blood pressure >90 mm Hg af ter 2 weeks. Treatment lasted for 12 weeks. Blood pressure was signifi cantly reduced in both groups by week 12, with normalization rates of 75.0% for amlodipine and 72.2% for nifedipine. There was also a signif icant increase in heart rate in both groups by week 1 (heart rate in t he erect position, +6.2 beats/min and +14.3 beats/min for amlodipine a nd nifedipine, respectively). No changes were observed in body weight or laboratory variables. Three patients in the nifedipine group withdr ew from the study because of adverse effects (headache, two patients; severe palpitations/tachycardia, one patient). Other adverse effects, including pedal edema, frequent micturition, and dizziness, were mild and transient in most cases. Amlodipine and nifedipine have similar an tihypertensive effects; amlodipine appeared to be better tolerated.