Comparison of the antihypertensive efficiency of nitrendipine, metoprolol, mepindolol and enalapril using ambulatory 24-hour blood pressure monitoring

Schrader, J; Schoel, G.; Buhr-Schinner, Heike; Kandt, M; Warneke, G.; Armstrong, Victor W.; Scheler, F.

doi:10.1016/0002-9149(90)90935-t

Cited by 22 publications

(9 citation statements)

References 26 publications

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“…This confirms earlier findings, comparing enalapril with labetalol, in which the early-morning pressure surge was controlled with labetalol, but not with enalapril [9]. The effective ness of once-daily enalapril was reduced in our patients at trough, confirming earlier findings [10][11][12][13], However, cnalapril is often prescribed at once-daily doses at the present time. In this trial, sustained-rcleased nifedipine lead to a 20% increase in sympathoadrenal tone in our supine patients, which was much smaller than the 50% increment in another group of our patients with hyperten sion and stable angina after the immediate-release formu lation [14], On the other hand, after enalapril.…”

Section: Discussionsupporting

confidence: 91%

Equivalent Reduction of Proteinuria in Hypertensives by either Nifedipine GITS or Enalapril: Disparate Effects on Neurohormones and Ambulatory Blood Pressure and the Influence of Salt

DeQuattro

Lee²

1997

Cardiology

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Objective: We compared the efficacy of two classes of antihypertensive therapy on ambulatory blood pressure control and proteinuria in patients with hypertension. Furthermore, we determined the effects of the interaction of these therapies on neurohormonal activation and of the patients’ ambient sodium intake on the outcomes. Methods: Sustained-release nifedipine (nifedipine gastrointestinal therapeutic system, GITS) 30-120 mg/day was compared in a double-blind sequential randomized placebo-controlled trial with enalapril 5-30 mg/day regarding office and 24-hour blood pressure control, plasma renin activity, noradrenaline and adrenaline levels and 24-hour urinary protein and sodium in 46 elderly nondiabetic hypertensive patients in a 16- to 18-week trial. Results: Both nifedipine GITS and enalapril controlled ambulatory blood pressure during the day and at peak effect. Nifedipine GITS controlled ambulatory blood pressure during the early morning surge and at night time as well. Nifedipine GITS increased plasma renin activity and noradrenaline by 50 and 20%, respectively, compared to the 150 and 0% change produced by enalapril. Both nifedipine GITS and enalapril reduced proteinuria by 37%. Patients had increasing levels or proteinuria proportional to higher ambient sodium intake (r = 0.48; p < 0.01). This effect was accentuated during nifedipine GITS therapy as compared to enalapril. Conclusion: Nifedipine GITS was superior to enalapril in controlling ambulatory blood pressure, but they were equivalent in reducing proteinuria (37%). They had disparate effects on neural activation and the duration of action. Raised protein excretion appears to be associated with raised sodium intake. This was apparent especially during nifedipine XL therapy.

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Section: Discussionsupporting

confidence: 91%

Equivalent Reduction of Proteinuria in Hypertensives by either Nifedipine GITS or Enalapril: Disparate Effects on Neurohormones and Ambulatory Blood Pressure and the Influence of Salt

DeQuattro

Lee²

1997

Cardiology

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“…24-hour ambulatory blood pressure values are more robust and less influencable than office measurements and constitute, when elevated, an independent risk factor for hypertension-related damage [13]. This can be attributed, for one, to the frequency of the measured values during routine daily stress, which permits better evaluation of the blood pressure profile under therapy [14]. Using 24-hour ambulatory blood pressure monitoring avoids and reveals the true nature of the pronounced fluctuations between single measurements, such as those commonly seen in the case of "white coat" hypertension [15].…”

Section: Discussionmentioning

confidence: 99%

Renal Denervation: Results of a Single-Center Cohort Study

Luetkens

Wilhelm

Düsing

et al. 2014

Fortschr Röntgenstr

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Purpose: To investigate the effect of renal denervation on office-based and 24-h ambulatory blood pressure measurements (ABPM) in a highly selective patient population with drug-resistant hypertension. Materials and Methods: Patients with drug resistant hypertension eligible for renal denervation were included in the study population. Office blood pressure and ABPM were assessed prior to and after renal denervation. To detect procedure related renal or renal artery damage, magnetic resonance imaging (MRI) and angiography (MRA) were performed pre-interventional, one day post-interventional, and one month after renal denervation. Results: Mean follow-up time between renal denervation and blood pressure re-assessment was 9.5???3.9 months. Between August 2011 and March 2013, 17 patients prospectively underwent renal denervation. Pre-interventional mean office blood pressure and ABPM were 177.3???20.3/103.8???20.4?mmHg and 155.2???20.5/93.7???14.5?mmHg, respectively. Post-interventional, office blood pressure was significantly reduced to 144.7???14.9/89.5???12.1 (p??0.05). The number of prescribed antihypertensive drugs was unchanged after renal denervation (4.7???2.0 vs. 4.2???1.2, p?=?0.18). No renovascular complications were detected in follow-up MRI. Conclusion: After renal denervation, no significant decrease in ABPM was observed. These results may indicate a limited impact of renal denervation for drug resistant hypertension. Key Points: ??Renal denervation showed no significant effects on 24-h ambulatory blood pressure measurements. ??A significant decrease in office blood pressure measurements may be explained by a potential detection bias. ??Renal artery alterations were not observed on follow-up MRI scans. Citation Format: ??Luetkens J. A., Wilhelm K., D?sing R. et?al. Renal Denervation: Results of a Single-Center Cohort Study. Fortschr R?ntgenstr 2015; 187: 36???41

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“…ACE inhibitors and calcium antagonists have also been compared with 3-adrenoceptor blockers. Schrader et al (1990) concluded that metoprolol was the most effective drug at reducing both systolic and diastolic blood pressure when compared with nitrendipine, mepindolol and enalapril, whilst Applegate et al (1991) concluded that atenolol (50-100 mg), enalapril (5-20 mg) and diltiazem (120-360 mg) were equally effective at lowering diastolic blood pressure without significant differences in adverse effects in 240 older women with essential hypertension. Just over half of the patients treated with amlodipine in our study achieved satisfactory blood pressure control (DBP < 90 mm Hg) on 5 mg daily.…”

Section: Discussionmentioning

confidence: 99%

A comparison of amlodipine with enalapril in the treatment of moderate/severe hypertension.

Fowler

Webster

Lyons

et al. 1993

Brit J Clinical Pharma

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1. The safety and efficacy of amlodipine vs enalapril as monotherapy was evaluated in patients with moderate/severe hypertension (supine DBP 105‐125 mm Hg, SBP 140‐220 mm Hg). 2. After 2 weeks placebo treatment 31 patients were randomised by the technique of minimisation in an observer‐blind study to receive once daily treatment with either amlodipine (15 patients) 5‐10 mg, or enalapril (16 patients) 5‐20 mg for 8 weeks. The study design concluded with 2 weeks placebo treatment. In addition to clinic measurements, home blood pressure monitoring (Copal UA‐251) was performed during the study. 3. Clinic supine systolic blood pressure was reduced from 177 to 152 mm Hg (amlodipine) and 183 to 169 mm Hg (enalapril) (95% CI for the intergroup difference ‐ 22.1, 0.3, P = 0.06) after 8 weeks treatment. 4. Clinic supine diastolic blood pressure was reduced from 110 to 93 mm Hg (amlodipine) and 109‐102 mm Hg (enalapril) (95% CI for the intergroup difference ‐ 17.7, ‐2.7, P < 0.01) after 8 weeks treatment. 5. Home blood pressure recordings confirmed these reductions in blood pressure. Although the reduction in blood pressure was greater for the amlodipine treated group, the differences between treatments were not statistically significant. 6. Both drugs were reasonably well tolerated. The adverse events occurring most frequently in the amlodipine group were headache (5), peripheral oedema (3), upper respiratory infection (3) and anxiety (2). The adverse events occurring most frequently in the enalapril treated patients were headache (6), dizziness (3) and upper respiratory infection (2).

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Comparison of the antihypertensive efficiency of nitrendipine, metoprolol, mepindolol and enalapril using ambulatory 24-hour blood pressure monitoring

Cited by 22 publications

References 26 publications

Equivalent Reduction of Proteinuria in Hypertensives by either Nifedipine GITS or Enalapril: Disparate Effects on Neurohormones and Ambulatory Blood Pressure and the Influence of Salt

Equivalent Reduction of Proteinuria in Hypertensives by either Nifedipine GITS or Enalapril: Disparate Effects on Neurohormones and Ambulatory Blood Pressure and the Influence of Salt

Renal Denervation: Results of a Single-Center Cohort Study

A comparison of amlodipine with enalapril in the treatment of moderate/severe hypertension.

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