Cross-over comparison between captopril and nifedipine

In a cross-over study in 26 patients with mild to moderate essential hypertension The antihypertensive efficacy of captopril 25 mg b.i.d., nifedipine 20 mg b.i.d. and the combination both drugs in non-responders to monotherapy was compared. Of 26 captropril-treated patients 7 were non-responders and needed the addition of nifedipine; of 26 nifedipine-treated patients 3 needed additional captopril. Seven out of 26 patients treated with captopril, 22/26 patients given nifedipine and 9/10 patients receiving the combination reported side effects. In 3 nifedipine patients, 1 captopril patient and 1 patient on both drugs, treatment had to be stopped because of side effects. Captopril and nifedipine in these doses are about equally effective both after acute and chronic administration. The response-rate is somewhat higher with nifedipine, but the side effects are significantly less with captopril. There was no significant additive effect with the combination of the two drugs.