Continuous blood pressure monitoring - nitrendipine antihypertensive response

The antihypertensive efficacy of nitrendipine was investigated with 24 h ambulatory blood pressure (BP) monitoring in a double-blind, randomized study. Eleven patients participated in the nitrendipine group, and 12 in the propranolol group. The study design consisted of a 2 week placebo period, and 14 weeks of titration and efficacy phases. At the end of the placebo period and during the efficacy phase of drug treatment, 24 h ambulatory BP monitoring was carried out with a Del Mar Avionics P-3 machine. The nitrendipine group showed office systolic (S) BP to be 150 ± 15 mm Hg and diastolic (D) BP 100 ± 4 mm Hg on placebo, and SBP 134 ± 9 mm Hg and DBP 87 ± 4 mm Hg on active medication. Measurements made in a similar fashion with the propranolol group demonstrated a drop in SBP from 150 ± 13 to 133 ± 17 mm Hg and a decrease in DBP from 98 ± 2 to 85 ± 5 mm Hg with treatment. These BP drops were statistically significant (p<0.01). Mean 24 h ambulatory SBP and DBP dropped from 137 ± 16 to 128 ± 13 mm Hg and from 91 ± 6 to 87 ± 6 mm Hg, respectively. On propranolol, ambulatory SBP and DBP decreased from 142 ± 15 to 128 ± 18 mm Hg and from 89 ± 6 to 85 ± 7 mm Hg, respectively. In summary, this study demonstrated that nitrendipine is at least as effective as propranolol as an antihypertensive drug. The changes in BP were significant when the drug was administered two times daily, and DBP remained below 90 mm Hg most of the time during waking hours, as well as during sleep.