The aim of this study was to assess whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) affected blood pressure control in patients with essential hypertension who were being treated with lercanidipine, a vasoselective dihydropyridine calcium channel blocker. A total of 334 patients (mean [+ SD] age 61+10 years, 51% females) with mild-to-moderate essential hypertension and a history of osteoarthritis received lercanidipine (10 mg/day, up-titrated to 20 mg/day) for four to eight weeks until blood pressure control was achieved. At that point, treatment with NSAIDs (mostly diclofenac and naproxen) was started. Treatment with NSAIDs was maintained for four weeks.
At baseline, mean systolic blood pressure (SBP) was 157=/-10 mmHg, diastolic blood pressure (DBP) 92=/-6 mmHg, and heart rate 75=/-9 beats per minute. The administration of lercanidipine was associated with a significant decrease of SBP (to 139=/-9 mmHg) and DBP (to 82=/-7 mmHg) (p<0.001), without changes of heart rate.
SBP and DBP readings were not affected by the concomitant use of NSAIDs. Among 156 patients whose blood pressure was well controlled with lercanidipine, 128 (82%) continued to have well controlled SBP and DBP readings. The remaining 28 patients had SBP and DBP > 140 and/or 90 mmHg, but differences in blood pressure between the two groups were not significant. Eight patients (2.3%) had mild side effects and three were withdrawn due to ankle oedema.
We conclude that the use of NSAIDs did not significantly modify the antihypertensive effect of lercanidipine in essential hypertension. Therefore, lercanidipine is a useful drug for hypertensive patients with osteoarthritis who require treatment with NSAIDs.
