Influence of diabetes and type of hypertension on response to antihypertensive treatment

Morris J. Brown, Alain Castaigne, Peter W. De Leeuw, Giuseppe Mancia, Christopher R. Palmer, Talma Rosenthal, Luis M. Ruilope

Research output: Contribution to journalArticle

Abstract

The aim of our investigation was to determine whether the presence of additional risk factors or type of hypertension (diastolic or isolated systolic) influences blood pressure (BP) response to treatment. The International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study is a double-blinded outcome comparison of calcium channel blockade with diuretics in high-risk patients aged 55 to 80 years. Dynamic randomization between nifedipine once daily and hydrochlorothiazide/amiloride was performed to ensure that approximately equal numbers of patients in the 2 groups had each of the major cardiovascular risk factors. Patients with isolated systolic hypertension were also separately randomized. Atenolol or enalapril was the mandatory second-line drug. In 5669 patients who completed the 18-week titration, BP fell from 172±15/99±9 mm Hg (mean±SD) while receiving placebo to 139±12/82±7 mm Hg. Twenty-six percent of patients required 2 drugs, and 4% required 3 drugs. Patients with diabetes were the most resistant to treatment, requiring second and third drugs 40% and 100% more frequently than patients without diabetes and achieving marginally the highest final BP, for any risk group, of 141±13/82±8 mm Hg. Age, smoking, gender, hypercholesterolemia, left ventricular hypertrophy, and existing atherosclerosis had little (

Original languageEnglish
Pages (from-to)1038-1042
Number of pages5
JournalHypertension
Volume35
Issue number5
Publication statusPublished - May 2000

Keywords

  • Antihypertensive therapy
  • Calcium channel blockers
  • Cardiovascular diseases
  • Diabetes mellitus
  • Diuretics
  • Random allocation

ASJC Scopus subject areas

  • Internal Medicine

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  • Cite this

    Brown, M. J., Castaigne, A., De Leeuw, P. W., Mancia, G., Palmer, C. R., Rosenthal, T., & Ruilope, L. M. (2000). Influence of diabetes and type of hypertension on response to antihypertensive treatment. Hypertension, 35(5), 1038-1042.