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How Should Elderly Hypertensive Patients Be Treated? pp 157–170Cite as

Determinants of the Hypotensive Action of Nitrendipine and Atenolol in African Black Patients

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Summary

Thirty-five hypertensive black patients were double-blindly randomized to receive for 6 weeks either 100 mg atenolol per day (n = 17) or 20 mg nitrendipine daily (n = 18). Atenolol and nitrendipine significantly reduced blood pressure (P<0.05 or less); however, the magnitude of the decrease in supine systolic (-25.0 ± 13vs —10 ± 18 mmHg) and diastolic (-15.7 ± 8.5 vs -6.5 ± 11.2 mmHg) pressure, and in standing diastolic pressure (-17.6 ± 9.8 vs — 7.8 ± 13.0 mmHg) was more pronounced (P<0.05 or less) in the nitrendipine than in the atenolol group. Satisfactory control of blood pressure was obtained in 9 of the atenolol treated patients, and in 17 patients who received nitrendipine (P = 0.016). Pulse rate (P < 0.05 or less), plasma aldosterone (P < 0.05), and plasma renin activity (P = 0.09) decreased with atenolol, whereas no significant change occurred with nitrendipine. Pulse rate and plasma renin activity were lower (P < 0.05 or less) in the atenolol than in the nitrendipine group at the end of the study. Neither of the drugs significantly affected the red blood cell concentrations of sodium and potassium, the ouabain-sensitive efflux of sodium, or the other biochemical measurements.

In multiple regression analysis, the changes in supine systolic and diastolic pressure during nitrendipine were independently and negatively correlated with the patient’s age and initial blood pressure, and positively correlated with the change in supine pulse rate. The change in supine systolic pressure was also negatively correlated with initial erythrocyte sodium concentration.

The results indicate that nitrendipine was more efficient than atenolol in the hypertensive blacks entered in this study and suggest that besides older age and higher pretreatment blood pressure level, a higher intracellular sodium concentration could predict a greater response to nitrendipine.

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Authors and Affiliations

  1. Hypertension and Cardiovascular Rehabilitation Unit, University of Leuven, Leuven, Belgium

    P. Lijnen, R. Fagard & A. Amery

  2. Service de Endocrinology and Cardio-Renal Disease, Department of Internal Medicine, University of Kinshasa, Kinshasa, Zaïre

    J. R. M’Buyamba-Kabangu & B. Lepira

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  1. P. Lijnen
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  2. J. R. M’Buyamba-Kabangu
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  3. B. Lepira
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  4. R. Fagard
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  5. A. Amery
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Editors and Affiliations

  1. National Cardiovascular Center Hospital, Suita, Osaka, 565, Japan

    Teruo Omae (Director of Hospital) (Director of Hospital)

  2. Centro di Fisiologia Clinica e Ipertensione, Ospedale Maggiore di Milano, Instituto di Clinica Medica IV, Università di Milano, 20122, Milan, Italy

    Alberto Zanchetti (Professor) (Professor)

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© 1989 Springer Japan

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Lijnen, P., M’Buyamba-Kabangu, J.R., Lepira, B., Fagard, R., Amery, A. (1989). Determinants of the Hypotensive Action of Nitrendipine and Atenolol in African Black Patients. In: Omae, T., Zanchetti, A. (eds) How Should Elderly Hypertensive Patients Be Treated?. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68340-7_14

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  • DOI: https://doi.org/10.1007/978-4-431-68340-7_14

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68342-1

  • Online ISBN: 978-4-431-68340-7

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