Nifedipine monotherapy in the hypertensive elderly: a placebo-controlled clinical trial

A single-blind, placebo-controlled study was carried out to evaluate the suitability of slow-release nifedipine as antihypertensive monotherapy for the elderly. After a wash-out period, nifedipine slow-release tablets (20 mg twice daily) followed by matching placebo were administered, each for 4 weeks, to 23 patients over 60 years of age with essential mild to moderate hypertension. Nifedipine significantly reduced the systolic and diastolic blood pressure, and increased the pulse rate in both supine and upright positions. The pre-treatment supine systolic blood pressure proved the best single predictor of the blood pressure decreases in both positions. The decrease in mean arterial blood pressure correlated significantly with the nifedipine plasma concentration. Significant biochemical changes were observed with nifedipine, namely increased serum K+ level and decreased levels of serum Na+, cholesterol and triglycerides. Side-effects in general were mild and transient; nevertheless, 3 patients dropped out because of severe leg oedema.