Antihypertensive effects on blood pressure at rest and during exercise of calcium antagonists, beta-receptor blockers, and their combination in hypertensive patients.

The efficacy of nifedipine (40 mg), nitrendipine (20 mg), and acebutolol (400 mg) in reducing blood pressure at rest and during exercise was assessed in 35 hypertensive patients using a crossover study with 4-week treatment periods. In 20 patients, the antihypertensive effect of the combination of nifedipine and acebutolol was investigated. Both the calcium antagonists nitrendipine and nifedipine and the beta-receptor blocker acebutolol led to a significant (p less than 0.001) and almost identical reduction in systolic and diastolic blood pressures at rest. This was also the case with the diastolic blood pressure during and after work. Both calcium antagonists also revealed a significant (p less than 0.01; p less than 0.001) reduction in systolic exercise blood pressure; however, this effect was more pronounced with acebutolol. The additional use of nifedipine significantly enhanced the antihypertensive effect of acebutolol under resting conditions (p less than 0.05) but particularly during (p less than 0.01) and after (p less than 0.001) exercise. No adverse reactions to the monotherapy or to the nifedipine and acebutolol combination were found, in particular no effect on the PQ interval or the serum lipids. It is concluded that nifedipine and nitrendipine and their combination with beta-blockers appear to offer an alternative therapeutic approach in the management of arterial hypertension.

RCT Entities:   Population Interventions Outcomes