A multicenter long-term trial comparing doxazosin and nitrendipine in the treatment of mild to moderate essential hypertension associated with hypercholesterolemia

The objective of this study was to compare the efficacy and tolerability of doxazosin, a selective alpha 1 antagonist, versus nitrendipine, a calcium channel blocker, in 80 patients with mild to moderate hypertension associated with hypercholesterolemia. During this single-blind parallel trial, blood pressure, heart rate, serum lipid levels, and hematochemical parameters were monitored for 24 weeks. Both drugs were shown to be effective in lowering supine and standing blood pressure. Nitrendipine significantly increased heart rate ( P < 0.0001) while only doxazosin exerted a significant and positive effect in lowering cholesterol and triglycerides ( P < 0.0001). Moreover, doxazosin decreased low-density lipoprotein (LDL) and increased high-density lipoprotein (HDL), while the opposite was observed with nitrendipine. Less frequent and less severe adverse reactions were observed in the doxazosin group (three not clearly drug-related in the doxazosin group, 14 drug related in the nitrendipine group). The results of this study indicate that both drugs were effective in lowering blood pressure. A decrease in serum cholesterol was observed only in those patients treated with doxazosin. Furthermore, the incidence of side effects in patients treated with doxazosin was lower compared with those on nitrendipine. These data appear to encourage the use of doxazosin in the treatment of hypertension associated with hypercholesterolemia.