Prolonged calcium channel blocker therapy of hypertension.

The dihydropyridine calcium channel blocker nitrendipine was studied in 329 hypertensive patients at 12 separate centers for periods of 1 year or more. Patients with untreated supine diastolic blood pressures greater than 90 mm Hg were given nitrendipine 5 mg twice daily for 1 week; if the goal blood pressure was not achieved (supine diastolic blood pressure less than 90 mm Hg with a fall of at least 10 mm Hg), the dose was doubled, and if necessary it was doubled again after an additional week. By the end of titration, the goal blood pressure had been achieved in 138 patients (44%). During the subsequent 11 months of study, 155 patients continued to take nitrendipine alone; their posttitration supine diastolic blood pressure was 85 +/- 7 mm Hg, and at the end of the 1 year study it was 84 +/- 6 mm Hg. There were no significant changes in body weight or in heart rate. At their discretion, investigators could add other antihypertensive agents in patients not responding adequately to nitrendipine alone. In 41 patients with a supine diastolic blood pressure of 95 +/- 9 mm Hg after initial titration, propranolol was added to the nitrendipine and decreased the supine diastolic blood pressure to 88 +/- 8 mm Hg by the end of the study; and in another 76 patients with a posttitration supine diastolic blood pressure of 92 +/- 7 mm Hg, the addition of hydrochlorothiazide decreased the supine diastolic blood pressure to 86 +/- 7 mm Hg by the end of the study.(ABSTRACT TRUNCATED AT 250 WORDS)