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Treating Hypertension in Non‐insulin‐Dependent Diabetes: A Comparison of Atenolol, Nifedipine, and Captopril Combined with Bendrofluazide
Author(s) -
Corcoran J. S.,
Perkins J. E.,
Hoffbrand B. I.,
Yudkin J. S.
Publication year - 1987
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1987.tb00855.x
Subject(s) - medicine , captopril , atenolol , supine position , renal function , nifedipine , crossover study , creatinine , blood pressure , anesthesia , endocrinology , urology , placebo , alternative medicine , pathology , calcium
Twenty‐five of thirty NIDDS who remained hypertensive (diastolic >95 mmHg supine) after 4 weeks on bendrofluazide 2.5 mg daily (B), completed a single‐blind, observer‐blind randomized crossover study, in which the additional use of atenolol (50 mg daily) (A), slow‐release nifedipine (20 mg twice daily) (N), and captopril (25 mg twice daily) (C) was compared. Patients took each drug for 8 weeks with dose doubling at 4 weeks if supine diastolic remained >90 mmHg. All three combinations were more effective than bendrofluazide alone ( p <0.01). In nine patients studied 2 h after tablets at the end of each treatment period nifedipine was more effective than the other two drugs (B: 174/104 mmHg, A: 162/95 mmHg, −8%, N: 141/88 mmHg, −17%, C: 157/94 mmHg, − 10%, supine), whereas in 16 patients studied 15 h after their evening dose there was no significant difference. Fasting insulin and HbA 1 levels were not significantly different between groups. No drug had a significant adverse effect on creatinine, glomerular filtration rate, overnight urinary albumin excretion or foot transcutaneous oxygen levels (43°C). All three drugs studied were effective without deleterious effects on renal function or peripheral blood flow.