Significant cost-saving with modification of antihypertensive therapy.

Thirty patients attending Somerset Hospital Outpatient Department, Cape Town, who were on nifedipine for hypertension or chest pain, were followed up for 6 months after alternative therapy was instituted. After the change of treatment, blood pressure control improved and no serious side-effects were encountered. Reserpine combined with a thiazide was a major component of the new regimen which reduced the monthly cost per patient from R54 to R14, a saving of 73%. If this saving was extended to 5% of the potential hypertensive patients in the RSA it would amount to R8 million per month. Although a self-assessment depression inventory was completed by 21 patients, our study does not fully evaluate the impact on quality of life. The likelihood of side-effects is, however, small--provided that the maximum daily dose of reserpine does not exceed 0.1 mg. We feel that a more considered approach is needed in the choice of antihypertensive agents.