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Treating Hypertension in Non‐insulin‐Dependent Diabetes: A Comparison of Atenolol, Nifedipine, and Captopril Combined with Bendrofluazide

Twenty‐five of thirty NIDDS who remained hypertensive (diastolic >95 mmHg supine) after 4 weeks on bendrofluazide 2.5 mg daily (B), completed a single‐blind, observer‐blind randomized crossover study, in which the additional use of atenolol (50 mg daily) (A), slow‐release nifedipine (20 mg twice daily) (N), and captopril (25 mg twice daily) (C) was compared. Patients took each drug for 8 weeks with dose doubling at 4 weeks if supine diastolic remained >90 mmHg. All three combinations were more effective than bendrofluazide alone (p<0.01). In nine patients studied 2 h after tablets at the end of each treatment period nifedipine was more effective than the other two drugs (B: 174/104 mmHg, A: 162/95 mmHg, −8%, N: 141/88 mmHg, −17%, C: 157/94 mmHg, − 10%, supine), whereas in 16 patients studied 15 h after their evening dose there was no significant difference. Fasting insulin and HbA1 levels were not significantly different between groups. No drug had a significant adverse effect on creatinine, glomerular filtration rate, overnight urinary albumin excretion or foot transcutaneous oxygen levels (43°C). All three drugs studied were effective without deleterious effects on renal function or peripheral blood flow.