Evaluation of lacidipinc (a calcium blocker) in the treatment of hypertension in black African people: a double-blind comparison with hydrochlorothiazide

Abstract

Diuretics and calcium blockers are particularly effective in the treatment of hypertension in Blacks, who, characteristically, have low-renin hypertension. The efficacy and tolerable of lacidipine (a calcium) blocker of the dihydropyridine class) and hydrochlorothiazide (a diuretic) were compared in a 12 week double-blind randomised parallel group study of Nigerians with essential hypertension. Lacidipine was given at a starting dose of 4 me daily by mouth and increased to 6 mg if there was no satisfactory response at 4 weeks, and hydrochlorothiazide was stared at 25 mg daily by mouth and increased to 50 mg if necessary. Twenty-four patients (8 male) in the lacidipine group and 17 (5 male) in the hydrochlorothiazide group were evaluable at the end of the trial. In the lacidipine group, SBP was significantly reduced from 157 ± 14 mmHg to 146 ± 24 mmHg {P < 0.00001) and DBP from 90 ± 9 mmHG to 87 ± 15 mmHg (P < 0.00001) with BP normalisation rates of 67% and 79% at 4 weeks and 12 weeks, respectively. In the hydrochlorothiazide group, SBP was significantly reduced from 16.4 ± 19 mmHg to 141 ± 17 mmHg (P < 0.00001) and DBP from 102 ± 6 mmHG to 89 ± 7 mmHg (P < 0.00001) with normalisation rates of 77% and 82% at 4 weeks and 12 weeks respectively. The groups did not differ in BP reduction nor normalisation rates. There were no reported side effects.