Viskoper RJ, Bernink PJLM, Ziekenhuis M, Schelling A, Ribeiro
AB, Kantola IM, Wilkins MR, Kobrin I
A double-blind trial comparing mibefradil and amlodipine: long-
acting calcium antagonists with similar efficacy but different
tolerability profiles
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:81A 1997
This study compares the antihypertensives efficacy of amlodipine and
mibefradil, a new
T-type calcium channel blocker. The key result reported is the comparison of
10 mg of
amlodipine to 100 mg of mibefradil following 12 weeks of therapy. BP
responses were
similar (-11.5 vs. -13.2 mmHg, for amlodipine and mibefradil, respectively)
and the
investigators reported that mibefradil caused a lower rate of edema.
Comment: Mibefradil is an interesting new agent that blocks calcium
entry through
T-type calcium channels. Although one might expect that such an agent would
profoundly
affect cardiac conduction, such is not the case, and mibefradil is reported
to cause only
a modest decrease in heart rate. The hemodynamic action is vasodilation, yet
the
troublesome edema associated with L-type calcium channel blockers appears to
be less of a
problem. Mibefradil appears to be as effective as other first-line
antihypertensives and
may have benefits over traditional dihydropyridine calcium blockers.
(Alan Weder,
M.D., University of Michigan)
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12th Annual ASH Meeting
H: Drug therapy :
Calcium channel blockers