Use of nifedipine as the drug of third choice in management of hypertension.

Nifedipine has been used in the management of hypertension in 36 consecutive patients who could not tolerate, or were not controlled by, atenolol and thiazide diuretics. Mean supine blood pressure was reduced from 193/110 +/- 5/2 (SEM) mmHg to 162/91 +/- 5/2 mmHg at eight weeks and remained at that level for the six months of follow-up. Blood pressure reduction at four weeks was not always a predictor of final BP level. Eight patients could not tolerate atenolol, nine patients could not tolerate thiazide diuretics and four patients could not tolerate nifedipine. No significant changes in plasma urea, creatinine, sodium, potassium urate, 'total CO2' or glucose were observed. We conclude that nifedipine is a well-tolerated drug and may be useful after beta-blockers and thiazide have been tried in the management of hypertension.