Felodipine as a replacement for minoxidil in the treatment of severe hypertension

The new calcium antagonist felodipine has been compared withminoxidil in the management of severe hypertension in a groupof 17 men. Satisfactory control of blood pressure was achievedin all patients with a combination of beta blocker, loop diureticand minoxidil after inadequate control on a standard regimenof beta blocker, thiazide and vasodilator. The optimal doseof felodipine was titrated after a placebo phase. In a doubleblind crossover trial blood pressure on felodipine (150/88±19/8mmHg, SD) was the same as on minoxidil (148/87±23/11mmHg, NS) and the postural difference was similar (NS) on bothdrug regimens. Body weight was lower on the felodipine regimen(P<0.01), as was supine heart rate (P<0.05). There wasa small rise in plasma liver enzymes on felodipine therapy (P<0.01).Felodipine was well tolerated and may be useful in the managementof severe hypertension.