Once- vs. Twice-Daily Nitrendipine in the Treatment of Mild to Moderate Hypertension

Antihypertensive Efficacy of Optimally Titrated Doses of Once-Daily Sustained-Release Diltiazem: A Placebo-Controlled Trial

“…After placebo run-in periods and treatment dura tions of 4 weeks to 1 year, 82,90 and 61 % of patients have responded when titration of amlodipine was scheduled by 485 the protocol [15][16][17], In a fixed-dose, parallel group study, responder rates were lower, 53, 48 and 63% for doses of 2.5, 5 and 10 mg of amlodipine. respectively [18], With other calcium antagonists such as nitrendipine, felodipine and isradipine, given on a once-a-day basis in similar pro tocols, responder rates have been of the same order of magnitude: 45-73% with nitrendipine [19][20][21][22], 48-75% with felodipine [23][24][25][26] and 54-66% with isradipine [27,28], The responder rate obtained with 200 mg diltiazem after a short 2-week period, 57%, stands already within those ranges. However, in the present trial, BP decrease was not negligible in the placebo group, yielding 37% of goal achievers after 10 weeks of treatment, a proportion usually encountered with this type of study protocol [18,20,22,[24][25][26][27], o.d.…”

“…In comparison with novel generation dihydropyridine derivatives, overall side effect rates are difficult to compare; reporting of events is very different from one study to another. Results vary, for example, from very low rates, 2% [15] to above 40% [21] and no conclusion can be reasonably drawn. Flushing, headache and peripheral edema are the adverse events most frequently encountered with these dihydro pyridine agents [29], Diltiazem was discontinued because of adverse events in 4 patients, while 7 receiving placebo had to be with drawn.…”