(Hypertension. 1999;34:1129-1133.)
© 1999 American Heart Association, Inc.
Scientific Contributions |
Randomized Double-Blind Comparison of a Calcium Antagonist and a Diuretic in Elderly Hypertensives
From the National Intervention Cooperative Study in Elderly Hypertensives Study Group, Tokyo, Japan.
Correspondence to Kizuku Kuramoto, MD, PhD, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
Abstract—Although
diuretics are recommended for the treatment of hypertension,
decreased diuretic use and increased calcium
antagonist use necessitate a comparison of the efficacy of
these drugs in preventing cardiovascular events.
Patients 
60 years of age with systolic blood pressure of 160
to 220 mm Hg and diastolic blood pressure <115
mm Hg were enrolled. Patients were randomly assigned to 20 mg of
sustained-release nicardipine hydrochloride twice daily
or 2 mg of trichlormethiazide once daily by the double-dummy method and
followed up for 5 years. A total of 414 patients were analyzed:
204 in the nicardipine group and 210 in the
diuretic group. Blood pressure at entry was 172/94 mm Hg
and 173/93 mm Hg, respectively, and decreased to 147/81
mm Hg and 147/79 mm Hg, respectively.
Cardiovascular morbidity rates per 1000 persons per
year were similar in the nicardipine and diuretic
groups (27.8 and 26.8, respectively; P=0.923). The sex-
and age-adjusted risk ratio for the nicardipine group was
0.973 (95% confidence interval, 0.514 to 1.839,
P=0.932). The calcium antagonist and
diuretic groups had a similarly decreased rate of
cardiovascular events.
Key Words: calcium antagonist • diuretics • hypertension • elderly
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