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Once Daily Coat-Core Nifedipine Has The Advantage Over Amlodipine In Essential Hypertension

Nifedipine formulations, administered once daily, are more effective than are amlodipine for the management of hypertensive patients, according to researchers.

Acknowledging that calcium channel antagonists can result in a poor prognosis through sympathetic hyperactivity, the researchers - from Shiga University of Medical Science, Otsu, Japan - undertook a comparative study of the two drugs in 36 patients with essential hypertension.

Patients who had been receiving sustained-release nifedipine were given amlodipine instead and those who had previously been treated with amlodipine now received coat-core nifedipine.

The researchers noted that hypertensive symptoms had no significant effect among patients receiving either amlodipine nor coat-core nifedipine. But, the plasma levels of norepinephrine, renin, and aldosterone were noticeably lower in patients whose sustained -release nifedipine was substituted for amlodipine.

There was also no significant change in the plasma levels of norepinephrine, renin and aldosterone following substitution of amlodipine by coat-core nifedipine.

The researchers concluded that coat-core nifedipine may not increase the sympathetic nerve activity seen in amlodipine at the effective anti-hypertensive concentrations of the two drugs. In addition, the nifedipine formulations duration of action is an important determinant for nifedipine- induced hyperactivity in the reflex sympathetic nerve and the renin-angiotensin systems.
Journal of Cardiovascular Pharmacology 2003:41 Supplement 1:S77-81. "Effects of long-acting calcium channel antagonists on neurohumoral factors: comparison of nifedipine coat-core with amlodipine"

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