Long-acting nifedipine for hypertensive patients in the Middle East and Morocco: observations on efficacy and tolerability of monotherapy or combination therapy

Abstract

Raafat AL Ghoneim,1 Abdalla Kamal Omar,2 VJ Sebastian,3 Roland Kassab,4 George Akijian,5 Meryem Hafiz,6 Birgit Schmidt7 1Department of Nephrology, Dr Bakhsh Hospital, Jeddah, Saudi Arabia; 2Open Specialist Clinics, Dallah Hospital, Riyadh, Saudi Arabia; 3Department of Cardiology, International Modern Hospital, Dubai, United Arab Emirates; 4Department of Cardiology, St Joseph University School of Medicine, Beirut, Lebanon; 5Internal Medicine (private clinic), Marka, Amman, Jordan; 6Medical Department, Bayer SA, Casablanca, Morocco; 7Global NIS, Bayer Vital GmbH, Leverkusen, Germany Background: The Middle Eastern and North African region of developing countries is associated with poor rates of blood pressure (BP) control and antihypertensive prescribing patterns. This post hoc analysis of data from an international observational study aimed to investigate the efficacy and tolerability of long-acting nifedipine (30 mg or 60 mg; monotherapy or in combination) in the Middle Eastern and Moroccan populations defined as having high cardiovascular risk. Methods: This was a prospective, noninterventional, multicenter observational study. Observations from patients (aged ≥ 18 years) with treated or untreated hypertension from the Middle East (Jordan, Saudi Arabia, Kuwait, Lebanon, Qatar, United Arab Emirates, and Yemen) and Morocco are presented. Hypertension grade and cardiovascular risk were defined at baseline, and systolic/diastolic BP change was defined at post-baseline visits (≤3). Adverse events and ratings of therapy efficacy and patient/physician satisfaction were recorded. Results: The study included 1466 patients from the Middle East and 524 from Morocco. Characteristics of the populations differed, with a more severe hypertension profile in Moroccan patients. Despite these differences, nifedipine reduced BP to a similar extent in each group, with efficacy dependent on cardiovascular risk factors such as hypertension grade and age. Few adverse drug reactions occurred and nifedipine was well-tolerated in both populations. Efficacy and satisfaction with therapy were rated highly. Conclusion: Good rates of BP control were observed with nifedipine in patients with moderate-to-severe hypertension and high added risk. Published data in these countries suggest poor antihypertensive prescribing patterns and BP control; these data confirm this trend and suggest that suboptimal dosing may be prevalent. Keywords: antihypertensive, safety, tolerability, hypertension, cardiovascular risk, blood pressure