Long-term antihypertensive effects and safety of nitrendipine in patients with mild, moderate, and severe hypertension.

A study of 31 patients with mild or moderate hypertension and 17 patients with severe hypertension was conducted to evaluate the long-term safety and efficacy of nitrendipine, a new calcium channel blocker with a long duration of action. Nitrendipine (5-40 mg bid) was given as monotherapy or in combination with hydrochlorothiazide and/or propranolol. Seventeen patients (54%) with mild to moderate hypertension were controlled with nitrendipine alone, but all except one patient with severe hypertension required combination therapy. In patients with mild or moderate hypertension, nitrendipine reduced supine blood pressure from a baseline mean 154/100 mm Hg to 136/87 mm Hg after 1 year of treatment (P less than .05). In patients with severe hypertension, supine blood pressure was reduced from 186/124 mm Hg to 148/91 mm Hg by the end of the planned treatment period (P less than .05; mean duration, 10 weeks). During extended observation, antihypertensive effect was sustained for up to 2.5 years and 1.6 years in patients with mild or moderate and severe hypertension, respectively. Nitrendipine was well tolerated; and only one patient, a moderate hypertensive, discontinued treatment because of pedal edema. The results of this long-term study show that nitrendipine alone or in combination with a diuretic and/or a beta blocker is a safe and effective agent for the treatment of patients with all degrees of hypertension.