To the Editor.
—We read with interest the article by Evans et al1 in the May 1984 Archives. Their results are similar to ours in demonstrating nifedipine efficacy as a substitute for hydralazine and captopril in combination antihypertensive therapy.2 Recently, McAreavey et al3 suggested hydralazine as the best third-line drug. Nifedipine was shown by Evans et al, Ueda and Marakami,4 and us2 to be a successful substitute for hydralazine in about 100 patients.A well-controlled study5 showed that nifedipine's hypotensive effect compared favorably with that of hydralazine shown in a similar study.6In summary, we feel that nifedipine should be considered as a most valuable vasodilator in combination antihypertensive therapy due to the efficacy, lower incidence of side effects (especially in the long-acting tablet preparation), and the protection from ischemic symptoms and events so prevalent in severely hypertensive patients.
Bursztyn M, Grossman E, Rosenthal T. Nifedipine in Antihypertensive Therapy. Arch Intern Med. 1985;145(5):953–954. doi:10.1001/archinte.1985.00360050223049