EFFECTS OF NIFEDIPINE SR AND ENALAPRIL ON OFFICE, HOME AND AMBULATORY BLOOD-PRESSURE IN WHITE-COAT SYSTEMIC HYPERTENSION

Among patients who were found to have hypertension by office or clinic blood pressure (BP) measurement, some appear to be normotensive when studied for full 24-hour periods by ambulatory BP monitoring, indicating so-called "office" or "white-coat" hypertension. Within groups of hypertensive patients with similar office BPs, those with higher than predicted ambulatory BP have greater prevalence of target-organ damage1,2 and a significantly greater 10-year incidence of fatal and unfatal events than those with lower than predicted ambulatory BP.3 Moreover, there is some indication that reducing BP too much may exert a deleterious rather than a beneficial effect on coronary events.4 In the present study, we examined and compared the effects of the long-acting calcium antagonist nifedipine slow-release tablet (nifedipine SR) with the effects of the long-acting angiotensin converting enzyme inhibitor enalapril on office, home and ambulatory BP measurements. We studied hypertensive patients with relatively higher and relatively lower ambulatory BPs. © 1990.