Nisoldipine coat-core and heart rate response during treatment of hypertension

Nisoldipine coat-core (nisoldipine CC), an extended-release once-daily formulation, is an effective treatment for mild-to-moderate hypertension, providing sustained blood pressure control over the 24-hour dosing interval. Nisoldipine CC is highly vascular selective. It causes neither reflex tachycardia nor symptomatic bradycardia; it lacks significant negative inotropy at therapeutic doses; and it does not affect circadian variation in blood pressure or heart rate. Data suggest that the lack of reflex sympathetic activation in response to the blood pressure-lowering effect of nisoldipine CC is due to the smooth onset of action of nisoldipine CC, causing resetting of the baroflex. The neutral heart rate profile of nisoldipine CC confers potential therapeutic advantages over several other calcium channel blockers, in particular, the short-acting agents, in the treatment of hypertension.