Nifedipine antihypertensive therapy

In antihypertension therapy, the most frequently used drugs are diltiazem (19.3.10), verapamil (19.3.15), and nifedipin (19.3.16), which appear to be equally effective drags for treating hypertension. Methods of syntheses have already been discussed in Chapter 19. 

Hamet P, Gong L. Antihypertensive therapy debate contribution from the Shanghai Trial Of Nifedipine in the Elderly (STONE). J Hypertens Suppl 1996 14(4) S9-14. 

What would be an advantage of antihypertensive therapy with nifedipine as opposed to verapamil ... 

Susceptibility factors Sex There are differences in blood pressure between the sexes, the mechanisms of which are unknown furthermore, it is not known whether sex can influence the response to antihypertensive therapy. In a prospective study 3535 untreated hypertensive Chinese patients were randomized to atenolol, sustained-release nifedipine, captopril, or hydrochlorothiazide for 8 weeks [32 ]. Women had significantly better pressure responses, but more adverse effects with sustained-release nifedipine and captopril than men. The authors suggested that sex should be taken into account when selecting antihypertensive drugs. 

The effects of antihypertensive agents have been evaluated in patients taking ciclosporin. Collectively, dihydropyridine calcium channel blockers that do not affect ciclosporin blood concentrations substantially or at all (felodipine, isradipine, and nifedipine) are usually considered to be the drugs of choice. However, the risk of gingival hyperplasia with nifedipine, which ciclosporin also causes, should be borne in mind. Combination therapy with angiotensin-converting enzyme inhibitors or beta-blockers, or the use of other calcium channel blockers (verapamil or diltiazem) should also be considered, but careful monitoring of ciclosporin blood concentrations is recommended with the latter because they inhibit ciclosporin metabolism. 

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