EVALUATION OF THE EFFICACY AND TOLERABILITY OF NITRENDIPINE IN REDUCING A BOTH PRESSURE AND LEFT-VENTRICULAR MASS IN HYPERTENSIVE TYPE-2 DIABETIC-PATIENTS

OBJECTIVE - To evaluate the efficacy and tolerability of nitrendipine in comparison with captopril in hypertensive diabetic patients with le ft ventricular hypertrophy (LVH). RESEARCH DESIGN AND METHODS - A tota l of 75 patients enrolled in this study presented stable type 2 diabet es (not treated with insulin) and mild-to-moderate hypertension with a left ventricular mass greater than or equal to 75 g/m(2) by two-dimen sional echocardiography. After a 4-week washout period, 38 patients we re assigned to treatment with captopril, and 37 patients to nitrendipi ne (random allocation). The duration of follow-up was 36 weeks. RESULT S - Patients of both groups were similar with regard to the duration o f diabetes and hypertension, systolic and diastolic blood pressure at rest, degree of LVH, metabolic control, and albumin excretion rate (AE R). Both drugs were equally effective in reducing systolic and diastol ic blood pressure (captopril: from 165 +/- 13/100 +/- 4 to 147 +/- 11/ 87 +/- 4 mmHg; nitrendipine: from 167 +/- 17/100 +/- 5 to 143 +/- 9/86 +/- 4 mmHg; P < 0.05) and in reversing LVH (nitrendipine: from 87 +/- 2 to 81 +/- 1 g/m(2); captopril: from 89 +/- 2 to 85 +/- 2 g/m(2); P = 0.0001). Neither the left ventricular end-diastolic volume index nor the left ventricular ejection fraction changed significantly during t he treatment period. CONCLUSIONS - Nitrendipine is as effective as cap topril in reducing both systolic and diastolic blood pressure and in r eversing LVH. Neither drug showed any negative side effects on fasting plasma glucose and glycated hemoglobin (HbA(1c)) levels, and both mai ntained constant AERs.