Middle term evaluation of amlodipine vs nitrendipine: efficacy, safety and metabolic effects in elderly hypertensive patients.

The aim of the study was to evaluate, in a population of elderly hypertensives, the efficacy for 24 hours, the safety and the effects on carbohydrates and lipids metabolism of amlodipine (A) and nitrendipine (N). After a 3-week placebo wash-out, 50 patients with mild to moderate essential hypertension (HBP) or isolated systolic hypertension (ISH), were randomized in 4 groups treated with once-daily A 5,10mg or N 10,20mg increasing until patients responded to treatment. All subjects were submitted to a 24-hour non invasive ambulatory blood pressure monitoring (ABPM) at the start of the study (t0) and after four weeks of therapy (t4). It was registered a mean daily reduction in the pressure load of 15.0% in group A, 14.1% in group B, 13.9% in group C and 15.6% in group D; (p < 0.001). 82% of the patients treated with A and 85% treated with N resulted "responder". The metabolic parameters considered showed no significant changes. The overall incidence of adverse effects were temporary and extremely limited (2%). As monotherapies, amlodipine and nitrendipine are both suitable for the management of mild to moderate hypertension in elderly.