THE TREATMENT OF HYPERTENSIVE PATIENTS WITH A CALCIUM-ANTAGONIST OR MOXONIDINE - A COMPARISON

Moxonidine represents a new generation of centrally acting antihypertensive drugs. Clinical experience shows that blood pressure normalizes in 50 and 80% of patients treated with 0.2 and 0.4 mg moxonidine, respectively in a dose-dependent manner. The antihypertensive potencies and tolerability of nifedipine and moxonidine were studied in 229 patients with primary hypertension (World Health Organization class I or II). Patients with baseline diastolic blood pressure of 95-114 mm Hg and systolic blood pressure of less than 240 mm Hg were included in the study. The average age of the randomized patients was 55.7 years, with approximately equal numbers of men and women. The screening phase of 7 days was followed by a 21-day single-blind placebo run-in phase and a 26-week active treatment phase. Initially, the patients received 0.2 mg moxonidine or 20 mg nifedipine (slow release) once a day. After 4 weeks of treatment, the dose was doubled (0.2 mg moxonidine b.i.d. or 20 mg nifedipine b.i.d.) if necessary in patients without normalization in blood pressure. Blood pressure decreased from 168.4 +/- 14.9/102.3 +/- 7.2 mm Hg to 144.6 +/- 18.9/86.0 +/- 11.5 mm Hg in the moxonidine group and from 167.6 +/- 15.2/102.1 +/- 6.5 mm Hg to 139.8 +/- 15.4/83.1 +/- 9.1 mm Hg in the nifedipine group. The drugs appear to be equieffective in the treatment of hypertension; 0.2 mg moxonidine once a day was equal to 20 mg/day nifedipine administered in sustained release form. Doubling the dose increased the responder rate to approximately 80%. The adverse event profile of moxonidine was somewhat better than that of nifedipine in this study.