To investigate the impact of treatment on cardiovascular mortality and morbidity, we assessed outcomes in patients with hypertension and diabetes who received co-amilozide or nifedipine in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension. Participants had to be 55 to 80 years of age, with hypertension (> or =150/95 or > or =160 mm Hg) and at least one additional cardiovascular risk factor. Patients received 30 mg nifedipine once daily or co-amilozide (25 mg hydrochlorothiazide and 2.5 mg amiloride) daily. Doses were doubled if target blood pressures (<140/90 mm Hg) were not achieved. Primary (composite of cardiovascular death, myocardial infarction, heart failure, and stroke) and secondary outcomes (composite of primary outcomes, including all-cause mortality and death from vascular and nonvascular causes) were assessed by means of intent-to-treat analyses. There was no significant difference in the incidence of primary outcomes between nifedipine-treated and co-amilozide-treated patients with diabetes at baseline (n=1302) (8.3% versus 8.4%; relative risk, 0.99, 95% CI, 0.69 to 1.42; P=1.00). A significant benefit for nifedipine-treated patients was seen for the composite secondary outcome (14.2% versus 18.7%; relative risk, 0.76, 95% CI, 0.59 to 0.97; P=0.03). Among patients without diabetes at baseline (n=5019), there was a significant difference in the incidence of new diabetes (nifedipine 4.3% versus co-amilozide 5.6%, P=0.023). Nifedipine GITS once daily is as effective as diuretic therapy in reducing cardiovascular complications in hypertensive diabetics. Nifedipine-treated patients were also less likely to have diabetes or have secondary events (a composite of all-cause mortality, death from a vascular cause, and death from a nonvascular cause) than co-amilozide recipients. Our results suggest that nifedipine could be considered as first-line therapy for hypertensive diabetics.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/01.HYP.0000057420.27692.AD | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A randomized controlled trial on the efficacy and safety of a calcium-channel blocker and an angiotensin-converting enzyme inhibitor in Chinese and European patients with hypertension.
Am J Hypertens
December 2024
IRCCS, Istituto Auxologic Italliano, Department of Cardiology, San Luca Hospital, Milan, Italy.
Article Synopsis
- - The study examined how effective and safe nifedipine GITS and ramipril are for treating hypertension in Chinese versus European patients through a post-hoc analysis of a multinational trial.
- - The research found that while both medications reduced blood pressure similarly across ethnic groups, ethnic differences impacted age, body mass index, and certain blood pressure measurements, and the response to treatment varied between the two groups.
- - The safety profiles noted significant differences, with fewer adverse events in Chinese patients taking nifedipine, while Europeans experienced more ankle edema with nifedipine and dry cough with ramipril.
Blood pressure variability assessed by office, home, and ambulatory measurements before and during antihypertensive drug treatment: a sub-analysis of the REVERENT randomized trial.
J Hypertens
August 2024
IRCCS, Istituto Auxologico Italiano, Department of Cardiology, San Luca Hospital.
Article Synopsis
- The study investigates how different methods of measuring blood pressure variability (OBP, HBP, and ABP) are related and agree with each other, particularly before and after starting treatment for high blood pressure.
- Participants included untreated hypertensive individuals who were given either ramipril or nifedipine GITS for 10 weeks, with their blood pressure variability assessed using standard deviation and coefficient of variation.
- Results showed only weak-to-moderate correlations between home and ambulatory BP measurements, indicating that while they can identify individuals with high blood pressure variability, they do not align well with office measurements.
Seasonal variation in ambulatory blood pressure control in patients on clinic blood pressure-guided antihypertensive treatment.
J Hypertens
May 2024
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: We investigated seasonal variation in ambulatory blood pressure control in hypertensive patients on clinic blood pressure-guided antihypertensive treatment.
Methods: The study participants were hypertensive patients enrolled in an 8-week therapeutic study. Antihypertensive treatment was initiated with long-acting dihydropyridine calcium channel blockers amlodipine 5 mg/day or the gastrointestinal therapeutic system (GITS) formulation of nifedipine 30 mg/day, with the possible up-titration to amlodipine 10 mg/day or nifedipine-GITS 60 mg/day at 4 weeks of follow-up.
Dosing Time Matters? Nighttime vs. Daytime Administration of Nifedipine Gastrointestinal Therapeutic System (GITS) or Amlodipine on Non-dipper Hypertension: A Randomized Controlled Trial of NARRAS.
Front Cardiovasc Med
November 2021
Department of Internal Medicine, North China Electric Power University Hospital, Beijing, China.
Non-dipper hypertension is often characterized by a blunted decrease of nocturnal blood pressure (BP) and is associated with increased risk of target organ damage and cardiovascular (CV) events, while the optimal treatment strategy is yet to be established. This trial was designed to evaluate whether nocturnal BP reduction and arterial stiffness improvement differ from antihypertensive agents and time of administration. Young and middle-aged adults (18-65 years) with non-dipper hypertension were randomly assigned to nifedipine GITS (gastrointestinal therapeutic system) 30 mg or amlodipine besylate 5 mg once daily for 8 weeks, either taken in the morning or at night.
View Article and Find Full Text PDFSerum uric acid change in relation to antihypertensive therapy with the dihydropyridine calcium channel blockers.
Blood Press
December 2021
Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Purpose: We investigated serum uric acid changes in relation to the achieved clinic and ambulatory blood pressure after 8 weeks of antihypertensive therapy with two dihydropyridine calcium channel blockers.
Materials And Methods: The study participants were patients with clinic and ambulatory hypertension, enrolled in a randomised controlled trial that compared amlodipine (5-10 mg, = 215) and nifedipine gastrointestinal therapeutic system (GITS, 30-60 mg, = 203). Hyperuricaemia was defined as a serum uric acid concentration of ≥420 µmol/L in men and ≥360 µmol/L in women.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!