Nifedipine-clonidine combination in essential hypertension. Hemodynamic and neurohumoral findings of the combination in comparison with the effect of the individual substances
Mitrovic, V.; Patyna, W.; von Bruchhausen, V.; Schlepper, M.
Fortschritte der Medizin 109(32): 663-666
1991
ISSN/ISBN: 0015-8178 PMID: 1769635 Document Number: 370614
In 10 patients with moderate essential hypertension, the neurohumoral and hemodynamic effects of 4 days' treatment with 2 x 75 micrograms clonidine (C), 2 x 20 mg nifedipine retard (N), and a combination of the two (C/N) were studied and compared with baseline values. The heart rate decreased significantly from a mean of 79 to 67 bpm (p less than 0.05) under C, increased again to 73 bpm (p greater than 0.05) under N, and decreased once more to 68 bpm (p less than 0.05) under C/N. The systolic blood pressure decreased from a mean of 184 to 171 under C, 168 after N, and 161 (p less than 0.01) under C/N; significant decreases of diastolic blood pressure were also observed (from 113 to 104 under C, 107 under N, 100 mmHg under C/N (p less than 0.05). Norepinephrine decreased from 440 to 281 under C (p less than 0.01), increased to 391 (p greater than 0.05) after N, and measured 404 pg/ml (p less than 0.05) under C/N. PRA decreased significantly under C, increased under N, and remained unchanged under C/N. These findings demonstrate that combined treatment with lowdose nifedipine and clonidine leads to an additive reduction of blood pressure. The disadvantage of neurohumoral counterregulation of nifedipine are neutralized by clonidine.
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