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The effects of nicardipine in elderly hypertensive patients
1Centro Fisiologia Clinica e Ipertensione, Ospedale Maggiore di Milano, Italy.
Insights
Elderly hypertension, often caused by stiff arteries, responds well to calcium antagonists like nicardipine. This study found nicardipine effective in reducing systolic blood pressure in older adults with hypertension.
Area of Science:
- Cardiology
- Gerontology
- Pharmacology
Background:
- Hypertension prevalence increases with age, with distinct hemodynamic patterns in the elderly compared to younger individuals.
- In older adults, hypertension is mainly due to reduced large vessel compliance and increased total peripheral resistance.
- Vasodilator drugs, particularly calcium antagonists, are hypothesized to be especially effective for hypertension in the elderly.
Purpose of the Study:
- To evaluate the efficacy and safety of nicardipine in treating hypertension in elderly patients.
- To investigate the correlation between pretreatment blood pressure and the antihypertensive effect of nicardipine.
- To compare the side effect profile of nicardipine in elderly versus younger hypertensive patients.
Main Methods:
- A 6-month, multicenter study involving 2,184 patients.
- Patients received nicardipine treatment, with or without other antihypertensive drugs.
- Analysis focused on the correlation between baseline blood pressure and blood pressure reduction, and incidence of side effects.
Main Results:
- A direct correlation was observed between pretreatment blood pressure and the degree of blood pressure reduction during nicardipine treatment.
- Isolated systolic hypertension showed significant reduction, while diastolic blood pressure remained largely unaffected.
- The incidence of side effects in elderly hypertensive patients was slightly lower than in younger patients.
Conclusions:
- Nicardipine is safe and effective for lowering blood pressure in elderly patients with hypertension, particularly for isolated systolic hypertension.
- The antihypertensive effect of nicardipine is correlated with the initial blood pressure levels.
- Elderly hypertensive patients, including those with comorbidities, tolerate nicardipine well, with a low incidence of side effects.
Abstract:
Hypertension becomes more prevalent with advancing age, and the hemodynamic pattern differs from that in younger patients. In the elderly, elevated blood pressure is primarily due to reduced compliance of large vessels, resulting in an increase in total peripheral resistance, but in younger subjects it mainly reflects an increase in cardiac output. Vasodilator drugs, such as calcium antagonists, might therefore be expected to be particularly effective in lowering blood pressure in the elderly. Clinical experience has confirmed the safety and antihypertensive efficacy of these drugs, with some workers suggesting that calcium antagonists are particularly effective in the elderly. A 6-month multicenter study involving 2,184 patients has shown a direct correlation between pretreatment blood pressure and the degree of blood pressure reduction observed during nicardipine treatment with or without other antihypertensive drugs. Isolated systolic hypertension was significantly reduced but diastolic blood pressure was not affected. The incidence of side effects among elderly hypertensive patients, both with and without concomitant disease, was slightly lower than in younger patients.