Effects of nifedipine GITS and diuretics in isolated systolic hypertension--a subanalysis of the INSIGHT study.

Abstract

AIMS:

This study tested the effects on cardiovascular outcomes of treatments based on nifedipine gastrointestinal therapeutic system (GITS) compared with the diuretic combination co-amilozide in a pre-specified subset of patients with isolated systolic hypertension (ISH) enrolled in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study.

MAJOR FINDINGS:

Of 6321 randomized patients, 1498 (23.7%) had ISH with a baseline mean BP of 173/88 mmHg in both treatment groups. Mean BP fell by 29/10 mmHg in the nifedipine and 30/10 mmHg in the diuretic group to a mean BP of 144/78 mmHg and 143/79 mmHg, respectively, at endpoint. The percentage of primary outcomes in patients with ISH was not significantly different between the two treatment groups (nifedipine GITS 6.0%, co-amilozide 6.6%). The number of ISH patients with composite secondary outcomes was 90 (12.2%) in the nifedipine GITS group and 110 (14.5%) in the co-amilozide group (not significant). The incidence rates of primary and secondary outcomes were similar in patients without ISH.

CONCLUSION:

In patients with ISH, nifedipine GITS and co-amilozide had similar effects on clinical outcomes and BP lowering. They lend support to international guidelines for the treatment of hypertension recommending the use of long-acting dihydropyridine calcium-channel blockers as one treatment option for patients with ISH.

• Authors: Guiseppe Mancia, Luis Ruilope, Christopher Palmer, Morris Brown, Alain Castaigne, Peter De Leeuw, Talma Rosental, Gilbert Wagener
• Journal: Blood pressure (Blood Press) Vol. 13 Issue 5 Pg. 310-5 ( 2004) ISSN: 0803-7051 [Print] England
• PMID: 15545155 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antihypertensive Agents
• Calcium Channel Blockers
• Diuretics
• Dosage Forms
• Drug Combinations
• Hydrochlorothiazide
• amiloride, hydrochlorothiazide drug combination
• Amiloride
• Nifedipine

Topics

• Aged
• Aged, 80 and over
• Amiloride (administration & dosage, therapeutic use)
• Antihypertensive Agents (administration & dosage, therapeutic use)
• Blood Pressure (drug effects)
• Calcium Channel Blockers (administration & dosage, therapeutic use)
• Diuretics (administration & dosage, therapeutic use)
• Dosage Forms
• Double-Blind Method
• Drug Combinations
• Drug Therapy, Combination
• Female
• Humans
• Hydrochlorothiazide (administration & dosage, therapeutic use)
• Hypertension (complications, drug therapy, physiopathology)
• Male
• Middle Aged
• Nifedipine (administration & dosage, therapeutic use)
• Prospective Studies