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A comparison of felodipine and nifedipine as monotherapy in patients with mild-to-moderate hypertension

, : A comparison of felodipine and nifedipine as monotherapy in patients with mild-to-moderate hypertension. Current Therapeutic Research. 55(6): 625-631

Felodipine is a vascular-selective calcium antagonist developed for the treatment of hypertension. The purpose of this study was to investigate whether felodipine extended release (ER) has benefit as monotherapy when compared with the established, widely used dihydropyridine, nifedipine retard (R). One hundred thirty-four patients with uncomplicated mild-to-moderate primary hypertension (seated diastolic blood pressure (DBP), 95 to 115 mm Hg) entered this multicenter, comparative, randomized, double-blind, parallel-group study of the efficacy and tolerability of felodipine ER versus nifedipine R. Following a 4-week run-in period, patients were randomized to receive either felodipine ER 5 mg once in the morning or nifedipine R 10 mg twice daily. If seated DBP was gt 90 mm Hg after 2 weeks of treatment, the doses were doubled and treatment continued for another 2 weeks. After 4 weeks of treatment, seated mean DBP values had decreased from 105 +- 6 mm Hg to 89 +- 7 mm Hg in the felodipine ER group and from 105 +- 6 mm Hg to 92 +- 8 mm Hg in the nifedipine R group. The mean reduction was 3 mm Hg greater with felodipine ER than with nifedipine R (95% confidence interval = -5.7 to -0.03; P = 0.03). Sixty-five percent of the patients in the felodipine ER group achieved a seated DBP ltoreq 90 mm Hg versus 59% in the nifedipine R group. Thirteen patients discontinued the study because of adverse events (five patients in the felodipine group and eight patients in the nifedipine group, one of whom died). The pattern of adverse events was similar in the two groups and they were generally mild. In this study, felodipine ER 5 to 10 mg once in the morning was shown to be more effective than nifedipine R 10 to 20 mg twice daily in reducing seated blood pressure and caused fewer patients to discontinue treatment.


DOI: 10.1016/s0011-393x(05)80795-7

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