Comparison ofnisoldipine andnifedipine asadditional treatment inhypertension inadequately controlled by atenolol

Summary: Twenty-eight patients (11Caucasian, 17black) whoseblood pressure wasmorethan 160/96 mmHgafter 4weeks onplacebo added toatenolol 100mg/day wererandomly given, inaddition, nisoldipine 10mgornifedipine 20mgeachtwice adayfor8weeks inadouble-blind cross-over study. There wasastatistically significant (P< 0.001) fall inblood pressure with nochange inheart rate, both supine anderect, onboth drugs. There werenosignificant differences between nisoldipine andnifedipine. Adverse effects wererecorded in15%,17%and35%ofthepatients available forsafety comparison for placebo, nisoldipine andnifedipine, respectively. There werenosignificant differences between theblack andCaucasian patients inblood pressure responses, although thestudy hadonly alowpowertodetect these. However, thefasting serumtriglyceride levels attheendofbothcalcium antagonist treatment periods werehighly significantly lower intheblack patients compared withtheCaucausian patients. Nisoldipine, which hasahigher coronary vascular selectivity andless negative inotropism thannifedipine, isaseffective andaswell tolerated asnifedipine inpatients whose hypertension isinadequately controlled onatenolol. Itmayhaveaspecial role inhypertensive patients with impaired left ventricular function.