Comparisons of once-daily nilvadipine with enalapril and diuretic in patients with essential hypertension.

The antihypertensive efficacy of the new dihydropyridine derivative nilvadipine given once daily was compared in two randomized, double-blind studies with that of hydrochlorothiazide/triamterene (HCT/T) and of enalapril. In the first study, arterial pressures were compared after 4 weeks of therapy with nilvadipine (16 mg q.d.) or HCT/T (25/50 mg q.d.) in patients with mild-to-moderate hypertension in a parallel-group design. The combination of both treatments was administered after 4 weeks if diastolic arterial pressures were > 90 mm Hg. The blood pressure (BP) in the nilvadipine group (n = 125) was 161/102 +/- 17/7 (mean +/- SD) mm Hg after a 2-week placebo period and decreased after 4 weeks by -16/-13 +/- 22/12 mm Hg. The BP decreased in the HCT/T group (n = 124) compared to the nilvadipine group to a similar degree (p = 0.91, n.s.) from 160/103 +/- 17/8 mm Hg by -17/-13 +/- 18/11 mm Hg. A combination therapy was started after 4 weeks in 39 patients in the nilvadipine group and in 34 patients in the HCT/T group. This led independently of the treatment sequence, to a similar decrease in BP in the nilvadipine group (-17/7 +/- 16/10 mm Hg) and in the HCT/T group (-12/9 +/- 16/9 mm Hg). In the second study, the antihypertensive effect of nilvadipine (1 x .8 mg) was compared with that of enalapril (1 x 10 mg) in a randomized, double-blind, crossover design. Sixty-one patients with essential hypertension (WHO I-II) were treated over two 4-week periods following placebo periods of 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)