Nifedipine in Antihypertensive Therapy

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.