To determine the optimal therapeutic dose and the effectiveness of a single daily dose of nitrendipine. 107 patients of both sexes, aged 29–67 years (mean, 51 years), suffering from mild and moderate arterial hypertension with diastolic blood pressure (DBP) of 95–114 mm Hg, were submitted to increasing doses of the drug, beginning with 10 mg b.i.d. in a open trial. All of them were controlled hourly from 8 a.m. to 4 p.m. every 14 days. Treatment was considered effective when DBP reached 90 mm Hg in at least 5 of the 8 hourly controls. When doses were effective, an extra 14 day period was carried out with the same dose administered q.i.d. Ninety-seven patients (90.7%) responded successfully to the drug, and in 70 (65.4 %) a dose of 10–20 mg daily was enough to achieve DBP normal levels. Those who did not respond with up to 60 mg daily were considered therapeutic failures. The onset of action was apparent within 1 h after intake and persisted throughout the day. Thirty-seven patients with successful responses agreed to be included in a long-term treatment with the same doses that normalized their DBP. All of them were controlled every 14 days during a year. Only 31 completed the 24 periods of 2 weeks each, and 6 withdrew from the study at different times; therefore, only 837 controls were made. Eighteen patients (48.6%) continued with the initial dose or were able to reduce it, 11 (29.7%) had to increase it, and 8 (21.6%) remained unchanged. Considering the 837 controlled periods, it was possible to maintain the initial dose in 442 (52.8;), and to reduce or discontinue it in 271 (32.4%), and it was necessary to increase the dose in 124 (14.8%). Only 23 patients (21.5%) showed side effects — mainly those related to vascular type (headaches and rashes) — that may be attributed to the drug. In no case was it necessary to discontinue the treatment. We concluded that nitrendipine is a well-tolerated and effective drug in the treatment of mild and moderate arterial hypertension with oncedaily intake, and its effects continue in long-term treatment.
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