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Regression of cardiovascular structural changes after long-term antihypertensive treatment with the calcium
E Agabiti-Rosei1, M L Muiesan, D Rizzoni
1Cattedra di Terapia Medica, UOP Scienze Mediche, University of Brescia, Italy.
Insights
Nitrendipine, a daily antihypertensive, significantly reduced blood pressure and left ventricular mass in hypertensive patients. This calcium antagonist also improved vascular resistance, indicating potential for reversing cardiovascular structural changes.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Cardiovascular structural changes are a primary target for antihypertensive therapy.
- Nitrendipine, a dihydropyridine calcium antagonist, is administered once daily.
- Animal studies suggest nitrendipine reduces blood pressure, left ventricular mass, and vascular lesions.
Purpose of the Study:
- To evaluate the effects of nitrendipine on cardiovascular structural changes in hypertensive patients.
- To assess nitrendipine's impact on left ventricular mass and vascular resistance.
Main Methods:
- A study involving 10 hypertensive patients treated with nitrendipine (20 mg once daily).
- Measurements included ambulatory blood pressure monitoring, echocardiography for left ventricular mass and function, and venous occlusion plethysmography for minimal vascular resistance.
- Hormonal assays for plasma renin activity, catecholamines, and aldosterone were performed.
Main Results:
- Nitrendipine significantly reduced blood pressure and left ventricular mass index after 6 months.
- A significant decrease in forearm minimal vascular resistance was observed, indicating improved vascular tone.
- Heart rate slightly increased, while hormonal levels were also monitored.
Conclusions:
- Once-daily nitrendipine treatment effectively reduces blood pressure and left ventricular mass in hypertensive patients.
- Nitrendipine demonstrates potential in reversing vascular structural changes by decreasing minimal vascular resistance.
- Further research is warranted to confirm these findings and explore long-term benefits.
Abstract:
Regression of cardiovascular structural changes is a main goal of antihypertensive treatment. Nitrendipine is a calcium antagonist of the dihydropiridine group that may be given once daily. In different animal models of experimental hypertension, nitrendipine was shown to reduce blood pressure (BP) and left ventricular (LV) mass, to prevent early mortality, and to limit the development of vascular lesions. It has also been proposed that nitrendipine is able to preserve tissue integrity and increase life span in malignant hypertension, because it prevents a deleterious calcium overload in the heart and arterial vessels. In humans, the effect of nitrendipine on LV mass has been evaluated in a limited number of studies with conflicting results. It has been shown that nitrendipine is able to increase the compliance of large arteries; its effect on vascular structural changes has never been reported. In this study, nitrendipine (20 mg o.d.) was given to 10 hypertensive patients. BP, (ambulatory BP monitoring) heart rate (HR), LV mass and function (TM echo, 2D guided), forearm minimal vascular resistance (min VR = BP/max blood flow--venous occlusion plethysmography--taken as an index of vascular STC), plasma renin activity (PRA), plasma catecholamines (NE and E), and aldosterone (ALD) were measured during placebo, after 2 and 6 months of treatment. BP was significantly reduced and HR was slightly increased. After 6 months of treatment a significant reduction of LV mass index (p less than 0.001) and of min VR (p less than 0.002) was observed.(ABSTRACT TRUNCATED AT 250 WORDS)