Antihypertensive effect of nifedipine and its relationship to severity of hypertension.

The antihypertensive effect of nifedipine (Adalat), a Ca2+-antagonistic drug, was studied in patients with mild or severe hypertension. In both short- and long-term trials, nifedipine exerted a strong hypotensive effect, more pronounced in patients with severe than in cases with mild hypertension. The results of our short-term study showed a positive correlation between the maximum fall in blood pressure induced by nifedipine and pretreatment systolic blood pressure values or the total severity index score of hypertension. In our long-term trial, we also observed a positive correlation between maximum reduction of blood pressure--induced by nifedipine--and pretreatment values. However, no correlation between reduction of blood pressure and total severity index score of hypertension could be established. Our results indicate that nifedipine could be effective in the management of severe hypertension. The hypotensive action of nifedipine, at least partly due to its Ca2+ influx blocking action, suggests that etiologically hypertension may be connected with an abnormal calcium metabolism of the cardiovascular muscle cells.