(Hypertension. 2001;37:1410.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Calcium Channel Blocker Nifedipine Slows Down Progression of Coronary Calcification in Hypertensive Patients Compared With Diuretics
From the Cardiac Rehabilitation Institute, Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Sackler School of Medicine, Tel-Aviv, Israel.
Correspondence to Michael Motro, MD, Sheba Medical Center, Tel-Hashomer 52621, Israel. E-mail: motrom{at}post.tau.ac.il
Abstract—Calcium
controls numerous events within the vessel wall. Permeability of the
endothelium is calcium dependent, as are platelet
activation and adhesion, vascular smooth muscle proliferation and
migration, and synthesis of fibrous connective tissue. Double-helix
computerized tomography is a noninvasive technique that can detect,
measure, and compare coronary calcification in the
coronary arteries. Using this method, our objective was to
determine whether administration of
nifedipine once daily in lieu of
diuretics in high-risk hypertensive patients will arrest or
slow down the progression of coronary artery calcification. The
study was designed as a side arm of INSIGHT (International
Nifedipine Study: Intervention as Goal for Hypertension
Therapy), aimed to show the efficacy of nifedipine once
daily versus co-amilozide (hydrochlorothiazide 25 mg,
amiloride 2.5 mg) in high-risk hypertensive patients. A total of 201
patients with a total calcium score of 
10 at the onset of study who
underwent an annual double-helix computerized tomography for 3 years
were analyzed for efficacy. Inhibition of coronary
calcium progression was significant in the nifedipine
versus the co-amilozide group during the first year (3.18% versus
27%, respectively, P=0.02),
not significant during the second year (28.5% versus 47%,
respectively, P=0.14), and
significant during the third year (40% versus 78%, respectively,
P=0.02). The results point to a
slower progression of coronary calcification in hypertensive
patients on nifedipine once daily versus
co-amilozide.
Key Words: coronary calcification • nifedipine • co-amilozide • computed tomography
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