Comparison of nifedipine (retard formulation) and mefruside in the treatment of mild to moderate hypertension-a prospective randomized double-blind crossover study in general practice

Abstract

Twenty-two patients under general practice care, suffering mild to moderate hypertension and receiving no active treatment had three baseline blood pressure measurements taken during a single blind 4- week placebo run-inperiod. One patient wits secondarily excluded at this stage because of a placebo response and one patient dropped out for personal reasons. The remaining 20 patients were randomized to receive either nifedipine 20 mg twice aday or mefruside 25 mg once a day in a classical two-period crossover designwith 8-week treatment periods separated by a 4-week single-blind placebo washout. During 8 weeks nifedipine therapy the mean supine blood pressure wasreduced from 173 (s.d. = 15 4)/107(s.d. =6-4) mmHg to 150(s.d. - 1617)/ 93(s.d. = 10*8) mmHg whereas the corresponding reduction for mefruside was from 174(s.d. = 15-9)/ 107(s.d. =9-4) mmHg to 153(s.d. = 19 1)/94(s.d. =97)mmHg. Neither drug affected postural changes in blood pressure. Standing blood pressure measurements under 8 weeks nifedipine therapy fell from 172(s.d. = 12.3)/103(s.d. =5.6) mmHg to 150(s.d. - 17 9)/94(s.d. = 10.0) mmHg with corresponding changes for mefruside being 174(s.d. = 14.7)/ 106(s.d. = 910) mmHg to 150(s.d. = 20.2)/95(s.d. = 9.4) mmHg. Since blood pressures returned to within 4% of baseline values by the end of the placebo washout period it can be inferred that each therapy was a significant (P<0-05 for all blood pressure variables) antihypertensive treatment in its own right.