Related Experiment Videos
Effects of sustained-release nicardipine on regression of left ventricular hypertrophy in systemic hypertension
1University of California, San Diego.
Insights
Sustained-release nicardipine effectively lowered blood pressure in patients with hypertension over a 6-week and 1-year period. The medication did not significantly alter left ventricular mass or function in the short term.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Systemic hypertension poses significant cardiovascular risks.
- Calcium antagonists are a key therapeutic class for managing hypertension.
- Understanding the long-term effects of sustained-release formulations is crucial.
Purpose of the Study:
- To evaluate the impact of sustained-release nicardipine on blood pressure.
- To assess changes in left ventricular (LV) mass and function.
- To investigate neurohumoral responses to nicardipine therapy.
Main Methods:
- Double-blind, placebo-controlled study followed by an open-label long-term phase.
- 28 patients with mild to moderate hypertension participated.
- Measurements included blood pressure, Doppler echocardiography, and plasma neurohormone levels.
Main Results:
- Nicardipine significantly reduced systolic and diastolic blood pressure within 6 weeks (p < 0.001) and maintained this reduction over 1 year (p < 0.01).
- No significant changes in Doppler mitral inflow, LV function, wall thickness, or mass were observed during the 6-week phase.
- Initial increases in norepinephrine and renin returned to baseline after 6 weeks; no adrenomedullary stimulation was noted.
Conclusions:
- Sustained-release nicardipine is effective in lowering blood pressure in hypertensive patients.
- Short-term administration does not appear to adversely affect LV structure or function.
- The drug shows a favorable short-term neurohumoral profile without significant stimulation of catecholamines.
Abstract:
The effects of a sustained-release formulation of the calcium antagonist nicardipine on left ventricular (LV) mass, Doppler transmitral velocity profiles and plasma neurohumoral studies were analyzed in patients with mild to moderate systemic hypertension. A double-blind placebo control phase in 28 patients was carried out for 6 weeks with a subgroup of 13 subsequently entering an open-label long-term phase for 1 year. Nicardipine produced a significant decrease in systolic and diastolic pressure over the 6-week phase (158 +/- 15 to 142 +/- 9 mm Hg, and 100 +/- 5 to 89 +/- 9 mm Hg, respectively, both p less than 0.001). No significant differences in Doppler measures of mitral inflow or echocardiographic measures of LV function, wall thickness or mass were noted in the 6-week phase of the study. Although nicardipine increased both norepinephrine and renin values after the first dose, these levels had returned to baseline in most patients after 6 weeks. In addition, there was no evidence for stimulation of adrenomedullary activity because nicardipine had no effect on epinephrine or dopamine-B-hydroxylase levels at first dose or after 6 weeks. In the 13 patients treated for 1 year, systolic and diastolic pressure remained significantly decreased compared with pressure before therapy (135 +/- 9 vs 147 +/- 15 mm Hg, and 85 +/- 6 vs 97 +/- 9 mm Hg, both p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)