Original Papers: Aspects of therapeutics: PDF OnlyInfluence of non-steroidal anti-inflammatory drugs on renal function and 24 h ambulatory blood pressure-reducing effects of enalapril and nifedipine gastrointestinal therapeutic system in hypertensive patientsPolónia, Jorge; Boaventura, Isabel; Gama, Guilherme; Camões, Isabel; Bernardo, Fátima; Andrade, Paulo; Nunes, José P.; Brandão, Fernando; Cerqueira-Gomes, MárioAuthor Information From the Clinical Pharmacology Unit, Institute of Pharmacology and Therapeutics, Service of Medicine 3, Faculty of Medicine, Hospital de S. João, Porto, Portugal Journal of Hypertension: August 1995 - Volume 13 - Issue 8 - p 925-931 Buy Abstract Objective: To evaluate the influence of non-steroidal anti-inflammatory drugs (NSAIDs; aspirin and indomethacin) on the renal and antihypertensive effects of enalapril and nifedipine gastrointestinal therapeutic system (GITS) in patients with essential hypertension. Design and methods: In a crossover study, 18 patients on an unrestricted-salt diet were randomly assigned to receive either enalapril (20-40 mg/day) or nifedipine-GITS (30-60mg/day) for 4-8 weeks, followed by aspirin (100 mg/day for 2 weeks) and then indomethacin (75 mg/day for 1 week). Blood pressure was measured by 24 h ambulatory monitoring. Results: Enalapril and nifedipine-GITS significantly reduced blood pressure compared with placebo. Aspirin did not alter the antihypertensive effect of either drug. Indomethacin attenuated (by 45%) the antihypertensive effect of enalapril throughout the 24 h period of evaluation, but did not interfere with the effect of nifedipine. Furthermore, indomethacin significantly reduced the fractional excretion of sodium and plasma levels of prostaglandins in a similar way when added to either the enalapril or the nifedipine regimen. Conclusions: Vasodilatory prostaglandins are probably involved in the antihypertensive effects of enalapril but not of nifedipine, and this interaction seems to be independent of any indomethacin-induced decrease in renal sodium excretion. Nifedipine may be an appropriate drug to treat hypertensive patients requiring concomitant therapy with NSAID. © Lippincott-Raven Publishers.