The antihypertensive efficacy and the tolerability of nifedipine (NI, Adalat®) and the usefulness of its combination with a β1-selective blocking drug, acebutolol (AC), were studied in a placebo controlled trial on 15 patients with moderate hypertension. The study consisted of three phases: 1. An acute test, including the single blind comparison of three different single doses of NI (5, 10, 20 mg), alone and in combination with AC 200 mg, with placebo and with AC alone (200 mg), showed on early hypotensive effect, with no differences for the three doses of NI, reaching the maximum between 50 and 240 min, greater than the one of AC, and smaller in comparison with the one of the combinations, which did not differ at the three doses of NI. Heart rate (HR) and side effects increased with the increasing doses of NI, suggesting a lower tolerability for the greater doses. 2. A long-term treatment including a double-blind comparison of three separate periods of 4 weeks of treatment with NI (10 mg three times a day), AC (200 mg three times a day) and with the combination of the same doses, showed a significant reduction of systolic and diastolic blood pressure (BP) for each treatment, not significantly different at rest for the three single drugs but greater for the combined treatment, assuring also a better control of systolic BP during exercise. A reduced number of side effects was seen with the combined therapy which seems to contribute to a better compliance. 3. The left ventricular function was evaluated by first-pass radionuclide angiocardiography using a gamma camera: this study contributed to the unterstanding of the mechanism of the antihypertensive action. The reduction of BP, when significant, even if induced by AC, is parallel to the reduction of systemic vascular resistance without any contribution of cardiac output. Both drugs (AC and NI) do not reveal any significant negative inotropic effect, even if used in combination. Minimal increase of ejection fraction was observed when NI was added to AC, likely due to the reduced afterload because it is impossible to attribute it to the adrenergic drive blocked by AC. In conclusion NI and AC are rapid-acting, effective and safe antihypertensive drugs.
Acebutolol and nifedipine in the treatment of arterial hypertension: Efficacy and acceptability / O. D., Divitiis; M., Petitto; DI SOMMA, Salvatore; S., Fazio; M., Galderisi; B., Villari; V., Liguori; M., Santomauro. - In: ARZNEIMITTEL-FORSCHUNG. - ISSN 0004-4172. - STAMPA. - 34:6(1984), pp. 710-715.
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|Titolo:||Acebutolol and nifedipine in the treatment of arterial hypertension: Efficacy and acceptability|
|Data di pubblicazione:||1984|
|Citazione:||Acebutolol and nifedipine in the treatment of arterial hypertension: Efficacy and acceptability / O. D., Divitiis; M., Petitto; DI SOMMA, Salvatore; S., Fazio; M., Galderisi; B., Villari; V., Liguori; M., Santomauro. - In: ARZNEIMITTEL-FORSCHUNG. - ISSN 0004-4172. - STAMPA. - 34:6(1984), pp. 710-715.|
|Appartiene alla tipologia:||01a Articolo in rivista|