Barnidipine monotherapy and combination therapy in older patients with essential hypertension: A long-term study

The long-term (2 year) safety and efficacy of barnidipine was assessed in a n open-label, dose-titration, multicentre study of 236 patients aged greate r than or equal to 75 years with a sitting diastolic blood pressure (DBP) g reater than or equal to 95 mmHg. All eligible patients started treatment wi th barnidipine 10 mg once daily. After at least 4 weeks treatment, the dose of barnidipine was titrated upwards to 20 mg daily in patients who did not achieve normalisation of blood pressure (sitting DBP <90 mmHg). After at l east another 4 weeks of treatment an ACE inhibitor or diuretic was added if necessary. Barnidipine monotherapy was the final treatment in 74% of patients in the I TT population (50% barnidipine 10 mg, 24% barnidipine 20 mg). The overall r esponse rate was 84.1% at endpoint. Overall mean sitting DBP decreased by 1 8.4 mmHg from 102.1 mmHg at baseline to 83.7 mmHg at endpoint. Although a total of 82.2% of patients reported at least one adverse event, only 37.4% of patients experienced an adverse event that was possibly or pr obably related to the study medication. Many patients experienced adverse e vents associated with co-existing diseases common in older people. It can be concluded that barnidipine as monotherapy or in combination with ACE inhibitors or diuretics is safe and effective in older patients with es sential hypertension.