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Title: Nifedipine Could Be First-Line Therapy For Hypertensive Diabetics

URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&list_uids=12623939&dopt=Abstract

Hypertension 2003;41:3:431-436. "Outcomes With Nifedipine GITS or Co-Amilozide in Hypertensive Diabetics and Nondiabetics in Intervention as a Goal in Hypertension (INSIGHT)"
03/25/2003 02:36:02 PM
By David Loshak

Nifedipine, a calcium blocker, could be considered as first-line therapy for hypertensive diabetics. Investigators in Monza, Italy, assessed outcomes in patients aged 55 to 80 years with hypertension (>/=150/95 or >/=160 mm Hg) and diabetes, or at least one additional cardiovascular risk factor. Patients received nifedipine 30 mg or co-amilozide (25 mg hydrochlorothiazide and 2.5 mg amiloride) once daily. Doses were doubled if target blood pressures (<140/90 mm Hg) were not achieved. The primary outcome was a composite of cardiovascular death, myocardial infarction, heart failure and stroke. Secondary outcomes were a composite of primary outcomes, including all-cause mortality and death from vascular and nonvascular causes. The researchers used intent-to-treat analyses to assess both primary and secondary outcomes. There was no significant difference in the incidence of primary outcomes between the 1,302 nifedipine-treated and co-amilozide-treated patients with diabetes at baseline. There was a significant benefit for nifedipine-treated patients for the composite secondary outcome. Among the 5,019 patients without diabetes at baseline, there was a significant difference in the incidence of new diabetes. Nifedipine GITS, once daily, was as effective as diuretic therapy in reducing cardiovascular complications in hypertensive diabetics, the investigators said. Nifedipine-treated patients were also less likely than those given co-amilozide to have diabetes or to have secondary events (a composite of all-cause mortality, death from a vascular cause, and death from a nonvascular cause).

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&list_uids=12623939&dopt=Abstract

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