NITRENDIPINE AND MEFRUSIDE IN ELDERLY HYPERTENSIVES - EFFECTS ON BLOOD-PRESSURE, CARDIAC-OUTPUT, CEREBRAL BLOOD-FLOW AND METABOLIC PARAMETERS

In this multicentre, randomised, double-blind, crossover study, we eva luated and compared the effects of nitrendipine (a calcium entry block er of the dihydropyridine group) and mefruside (a diuretic) on BP, car diac output, cerebral blood flow and metabolic parameters in 22 elderl y hypertensives. Eight weeks of treatment with nitrendipine (27.3 mg d aily) and mefruside (30.7 mg daily) significantly reduced BP values to almost the same extent. Heart rate, cardiac output (n = 14), cerebral blood flow (n = 20), renin activity and aldosterone remained unchange d during nitrendipine and mefruside treatment. Nitrendipine did not al ter any metabolic parameter (electrolytes, lipid values and blood gluc ose); in patients treated with mefruside serum potassium fell by 0.4 m mol/l (P < 0.001). Minor adverse events were reported in both treatmen t groups, mostly due to vasodilation. We conclude that both drugs poss ess potent and comparable haemodynamic and anti-hypertensive propertie s. They reduce BP by reducing total peripheral vascular resistance wit h maintained autoregulation of cerebral blood flow. The metabolic dist urbances induced by mefruside seem to be less pronounced than that obs erved with other thiazide diuretics.