The Pharmaceutical Journal
Vol 270 No 7241 p390
22 March 2003

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Hypertension abstract (more)

Role for nifedipine in hypertensive diabetes patients

Nifedipine could be considered as first-line therapy for hypertensive patients with diabetes, say researchers. Their conclusion follows the finding that nifedipine is as effective as diuretic therapy in reducing cardiovascular complications in this group of patients.

In addition, they have shown that patients treated with nifedipine are less likely to develop diabetes or to have secondary cardiovascular events than patients treated with co-amilozide.

The researchers analysed data from INSIGHT, in which patients with hypertension and at least one other cardiovascular risk factor were randomised to receive either co-amilozide or nifedipine (Adalat LA) daily.

They found no difference in the incidence of cardiovascular death, myocardial infarction, heart failure and stroke (as a combined endpoint) between nifedipine-treated patients and co-amilozide treated patients who had diabetes at the start of the study.

Among patients without diabetes at baseline, 4.3 per cent of patients treated with nifedipine went on to develop the disease compared with 5.6 per cent of patients treated with co-amilozide (P=0.023).

"[Our data] provide further evidence that calcium antagonists are suitable for diabetic hypertensive patients, contrary to the contention that treatment should make selective use of drugs that interfere with the renin-angiotensin system," the researchers conclude.

The study, sponsored by Bayer, is published in Hypertension (2003;41:431).