ABSTRACT
A controlled, randomized, single-blind, parallel-group study compared the effects of nicardipine hydrochloride/hydrochlorothiazide (HCTZ) with those of pindolol/HCTZ in treatment of essential hypertension. The study included 43 patients aged 30-64 years with supine diastolic blood pressures between 95 and 125 mmHg at baseline. Patients initially received 50 mg/day HCTZ for 6 weeks and those patients whose diastolic blood pressure remained at or above 90 mmHg at week 6 (n = 29) completed a 6-week comparative phase in which they were given, in addition, either 30 mg nicardipine hydrochloride or 5 mg pindolol three times daily. Nicardipine was more effective than pindolol as a second-line treatment in controlling blood pressure but, because patients who were treated with nicardipine/HCTZ had higher baseline blood pressures, significance was lost when results were adjusted for the baseline blood pressure values. Treatment was described as 'very good' by 71.4% of patients in the nicardipine/HCTZ group and by 53.9% of those in the pindolol/HCTZ group; thus, both second-line antihypertensives were well accepted. Although 45% of patients in of each treatment group reported treatment-related adverse events, none experienced postural hypotension and no adverse event was unexpected.
Subject(s)
Hypertension/drug therapy , Nicardipine/therapeutic use , Pindolol/therapeutic use , Adult , Aged , Blood Pressure/drug effects , Female , Humans , Hydrochlorothiazide/therapeutic use , Hypertension/physiopathology , Male , Middle Aged , Posture , Supine PositionABSTRACT
The combined antihypertensive effects of a new 4-dihydropyridine derivate calcium antagonist, nicardipine, and propranolol, atenolol, labetalol, clonidine, prazosin or captopril were studied in 14 hypertensive outpatients. Nicardipine in combination with atenolol or clonidine most effectively lowered blood pressure. Prazosin combined with nicardipine had no additive antihypertensive effect at the doses used. Clonidine and prazosin in combination with nicardipine were not well tolerated. The antihypertensive effect of the drug combinations seemed to be related to their bradycardic effect.
Subject(s)
Calcium Channel Blockers/therapeutic use , Hypertension/drug therapy , Nicardipine/therapeutic use , Prazosin/therapeutic use , Adult , Aged , Drug Interactions , Drug Therapy, Combination , Female , Humans , Male , Middle AgedABSTRACT
This report reviews the available evidence for and against the combined use of clonidine and prazosin in treating hypertension. Clinical studies have resulted in modest or no enhancement of the antihypertensive effects when prazosin has been added to clonidine. This report discusses the possible mechanisms of an interaction of clonidine and prazosin, which may show cause that the antihypertensive effects of these drugs are not additive.
Subject(s)
Clonidine/therapeutic use , Hypertension/drug therapy , Prazosin/therapeutic use , Animals , Blood Pressure/drug effects , Drug Interactions , Drug Therapy, Combination , HumansABSTRACT
The antihypertensive effects of urapidil and clonidine have been studied in a double-blind cross-over trial in 11 hypertensive outpatients with mild to moderate hypertension, at rest and during isometric exercise. Urapidil 30 mg b.i.d. significantly decreased the standing diastolic blood pressure (p less than 0.05) and the systolic blood pressure at the end of isometric exercise (p less than 0.05). Clonidine 0.075-0.15 mg b.i.d. was more effective in decreasing both systolic and diastolic blood pressure in the supine and standing positions as well as during isometric work (p less than 0.05-0.001). Urapidil caused fewer side-effects than clonidine. Overall, in the doses used urapidil had a weaker antihypertensive effect and caused fewer side-effects than clonidine.
