Enalapril & Nifedipine in Essential Hypertension: Synergism of the Hypotensive Effects in Combination

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Abstract
Twelve male hypertensive patients who had required enalapril and nifedipine to control their blood pressure were entered into a study of modified 2 × 2 factorial design (3 week study periods) to determine the effect of each drug separately and in combination. Factorial analysis indicated that enalapril alone (20 mg/d) lowered supine blood pressure by 10±2/8±1 mmHg, nifedipine alone (30 mg/d) lowered supine blood pressure by 11±2/8±1 mmHg and there was a positive interactive effect of 10±3/7±2 mmHg (P < 0.001) such that the combination lowered supine blood pressure by 32±3/24±2 mmHg. The effects of the individual drugs were both significant (P < 0.001) but did not differ from each other. Enalapril and nifedipine are both effective antihypertensive drugs and in some hypertensive patients their effects appear to be synergistic.