Article Text

Download PDFPDF
Long acting nifedipine was as effective as hydrochlorothiazide plus amiloride for reducing mortality and morbidity in hypertension

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

 QUESTION: In patients with hypertension who are at high risk for cardiovascular (CV) events, is long acting nifedipine, a calcium channel blocker, as effective as co-amilozide (hydrochlorothiazide and amiloride) for preventing CV and cerebrovascular mortality and morbidity?


Randomised (allocation concealed*), blinded (patients, physicians, and outcome assessors),* placebo controlled trial with ≥3 years follow up (Intervention as a Goal in Hypertension Treatment [INSIGHT] trial).


703 centres in 8 countries in western Europe and Israel.


7343 patients with hypertension were enrolled, 6575 were randomised, and 6321 (mean age 65 y, 54% women) were studied after exclusion of 9 centres because of protocol violations. Patients were required to have ≥1 additional CV risk factor (hypercholesterolaemia, smoking, family history of early myocardial infarction [MI], left ventricular hypertrophy or strain, coronary artery disease, or peripheral vascular disease). Follow up was 94%.


3157 patients were analysed in the long acting nifedipine group (30 mg/d), and 3164 were in the co-amilozide group (hydrochlorothiazide, 25 mg/d, and amiloride, 2.5 mg/d). If hypertension persisted, the regimen was …

View Full Text


  • Source of funding: Bayer AG.

  • For correspondence: Professor M J Brown, Clinical Pharmacology Unit, Level 6, ACCI, Box 110, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. Fax +44 (0)1223 762576.

  • * See glossary.