ATENOLOL AND NIFEDIPINE VERSUS NITRENDIPI NE - COMPARISON OF THE EFFICACY AND TOLERANCE AMONG PATIENTS WITH MILD-TO-MODERATE HYPERTENSION BY 24-HOUR BLOOD-PRESSURE MONITORING

The aim of the presented multicentric, double-blind randomized study w as to compare the efficacy and tolerance of a fixed combination of ate nolol 50 mg and nifedipine 20 mg in a slow-release form versus nitrend ipine 20 mg on patients with mild-to-moderate arterial hypertension. A 2-week single-blind placebo phase was followed by a 4-week verum phas e in which the patients were given either atenolol and nifedipine or n itrendipine alone. The efficacy of the respective medication was measu red by accidental blood pressure taking or by 24-hour automated blood pressure monitoring before and after therapy. Eighty-six patients were included in the study, 78 patients finally entered the randomized ver um phase. For the combination of atenolol and nifedipine a significant ly higher reduction in blood pressure than in the nitrendipine group w as observed. The reduction was 17.2 mmHg vs. 8.2 mmHg in the systolic 24-hour average value and 11.7 vs. 4.7 mmHg in the diastolic 24-hour v alue, respectively. In addition to that the duration of action was mar kedly longer for atenolol/nifedipine. The tolerance for the combinatio n medication was better than for nitrendipine, 2 vs. 6 patients from t he nitrendipine group had to be excluded from the study due to serious side effects. Because of these results a combination therapy of ateno lol and nifedipine should be given preference over a therapy with nitr endipine alone in patients with mild-to moderate hypertension.