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A comparative study of atenolol/nifedipine and atenolol/diuretic in hypertension

K G Edwards, J A Tweed, P A Saul

    Pharmatherapeutica
    |January 1, 1986
    PubMed

    Insights

    Adding a diuretic to atenolol significantly improved blood pressure control in hypertensive patients compared to adding nifedipine. Both combination therapies were generally well-tolerated.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Clinical Hypertension

    Background:

    • Atenolol monotherapy is often insufficient for controlling hypertension.
    • Combination therapy is frequently required for optimal blood pressure management.

    Purpose of the Study:

    • To compare the efficacy and tolerance of atenolol combined with a diuretic versus atenolol combined with nifedipine in hypertensive patients.
    • To evaluate add-on treatment strategies for inadequately controlled hypertension.

    Main Methods:

    • Prospective, randomized, double-blind, between-patient study.
    • Ninety-eight hypertensive patients received atenolol plus either nifedipine or a diuretic (amiloride/hydrochlorothiazide) for 8 weeks.
    • Blood pressure was measured in lying and standing positions.

    Main Results:

    • Atenolol/diuretic resulted in a greater mean reduction in standing systolic blood pressure (28/12 mmHg) compared to atenolol/nifedipine (18/13 mmHg).
    • Significant improvement in lying systolic blood pressure was observed with the atenolol/diuretic combination.
    • Both regimens showed reasonable tolerance, with higher withdrawal rates for atenolol/diuretic (10/19) and atenolol/nifedipine (7/19) compared to atenolol alone (2/19).

    Conclusions:

    • Combination therapy with atenolol and a diuretic offers superior blood pressure control compared to atenolol and nifedipine for inadequately controlled hypertension.
    • Both combination therapies are generally well-tolerated, but diuretics may lead to slightly higher discontinuation rates due to side effects.

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