Comparative assessment of lacidipine and nifedipine GITS: Effects on blood pressure, platelet function, and insulin sensitivity in patients with hypertension

Abstract

ObjectiveThe aim of the present study was to assess the effects on blood pressure, platelet aggregation, and insulin sensitivity of lacidipine and nifedipine gastrointestinal therapeutic system (GITS) given once daily in a parallel-group, double-blind, randomized study of patients with mild to moderate hypertension. MethodsTwenty patients (12 men, 8 women) with mild to moderate hypertension aged 45 to 56 years (average age, 50 ± 2.3 years) were included. They received placebo for 4 weeks and were then randomly divided into 2 groups of 10 patients each. Nifedipine GITS 30 mg and lacidipine 4 mg were given for 16 weeks. Blood pressure and heart rate were measured at the clinic in the supine, sitting, and standing positions 24 ± 1 hours after the last dose. At the end of the placebo and active phases the following procedures were performed: a platelet aggregation test; determination of platelet malondialdehyde production; and determination of tolerance to 100 g of glucose by measuring plasma insulin. ResultsBoth drugs significantly reduced systolic and diastolic blood pressures to the same level; however, observable differences in the rate of reduction were noted. In week 1, systolic blood pressure decreased 15.15% in the nifedipine GITS group and 6.54% in the lacidipine group. Heart rate was increased slightly but significantly in the standing position in the nifedipine GITS group only. Neither of the drugs reduced platelet aggregation ex vivo, however, both modified malondialdehyde production, indicating an effect at the arachidonic acid metabolic pathway. ConclusionsThe effects of the drugs on the metabolism of carbohydrates were inconclusive. However, a tendency for lacidipine to improve insulin sensitivity and for nifedipine GITS to have the opposite effect was observed.