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Tolerability and safety of a calcium channel blocker in comparison with a diuretic in the treatment of elderly patients with hypertension: secondary analysis of the NICS-EH.
- Source :
-
Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2001 Sep; Vol. 24 (5), pp. 475-80. - Publication Year :
- 2001
-
Abstract
- A randomized prospective controlled study, the National Interventional Cooperative Study in Elderly Hypertensives (NICS-EH), previously demonstrated that the preventive effect of the long-acting calcium channel blocker nicardipine on the cardiovascular endpoint was similar to that of the diuretic, trichlormethiazide. The present report is a sub-analysis in which we compare the tolerability and safety of the calcium channel blocker with that of a diuretic in the long-term treatment of elderly hypertensives. A total of 429 elderly patients with hypertension were assigned to the nicardipine group or the diuretic group by the double-dummy method and were followed up for 5 years. Two hundred four patients in the nicardipine group and 210 patients in the diuretic group were analyzed. The incidences of fatal and nonfatal cardiovascular (CV) events in the two groups were comparable, and there was no significant difference in the cumulative event-free rate. However, the total incidence of adverse reactions, including non-CV events and unfavorable BP changes, was 31 cases (15.2%) in the nicardipine group, which was significantly lower than the 47 cases (22.4%) in the diuretic group (log-rank: p=0.026, G. Wilcoxon: p=0.01). The total number of medical endpoints, including CV events, the withdrawal of the patient from the study, was 52 (25.5%) in the nicardipine group, which was significantly lower than the 65 (31.0%) in the diuretic group (log-rank: p=0.078, G. Wilcoxon: p=0.044). It was concluded that sustained-release nicardipine is better tolerated, as it exhibits a lower incidence of medical-related withdrawals such as adverse drug reactions, non-cardiovascular events and unfavorable BP responses during the treatment.
- Subjects :
- Aged
Calcium Channel Blockers adverse effects
Disease-Free Survival
Diuretics
Follow-Up Studies
Humans
Hypertension mortality
Middle Aged
Nicardipine adverse effects
Patient Dropouts
Prospective Studies
Sodium Chloride Symporter Inhibitors administration & dosage
Trichlormethiazide administration & dosage
Calcium Channel Blockers administration & dosage
Hypertension drug therapy
Nicardipine administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0916-9636
- Volume :
- 24
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Hypertension research : official journal of the Japanese Society of Hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 11675939
- Full Text :
- https://doi.org/10.1291/hypres.24.475