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[Left ventricular function in arterial hypertension in relation to age. The short-term effects of nicardipine]
1Cattedra di Cardiologia, Università di Parma.
Insights
This study found that nicardipine improved left ventricular function in both hypertensive and healthy individuals. However, older hypertensive patients showed a less significant improvement in peak filling rate after nicardipine administration.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is associated with impaired left ventricular diastolic function.
- Age can influence cardiovascular responses to medications.
Purpose of the Study:
- To evaluate the age-related effects on left ventricular function following acute nicardipine administration.
- To compare the effects of nicardipine in hypertensive patients versus healthy controls, stratified by age.
Main Methods:
- Gated radionuclide left ventriculography was used to assess left ventricular function.
- 15 hypertensive males (younger/older than 60) and 15 healthy males (younger/older than 60) received 40 mg oral nicardipine.
- Measurements included ejection fraction (EF), peak ejection rate (PER), and peak filling rate (PFR) before and 90 minutes after nicardipine.
Main Results:
- Hypertensive patients had lower baseline peak ejection and filling rates compared to controls.
- Nicardipine significantly increased EF, PER, and PFR in both hypertensive and control groups.
- Older hypertensive patients showed a less pronounced increase in PFR after nicardipine compared to younger counterparts.
Conclusions:
- Nicardipine acutely improves left ventricular systolic and diastolic function in hypertensive and healthy individuals.
- Age may modulate the diastolic functional response to nicardipine, particularly in hypertensive patients.
- Hypertensive patients exhibit impaired diastolic function, which is partially improved by nicardipine.
Abstract:
The purpose of this study was to assess the age related effects on left ventricular function after acute administration of the calcium-antagonist nicardipine. Gated radionuclide left ventriculography was performed before and 90 min after 40 mg of oral nicardipine in a group of 15 male patients with essential hypertension (H), 8 younger (HY) and 7 older (HO) than 60 years, and in a control group of 15 male subjects without cardiovascular disease (C), 7 younger (CY) and 8 older (CO) than 60 years. Baseline ejection fraction (EF) was similar in groups H and C, while peak ejection (PER) and peak filling (PFR) rates were lower in hypertensive patients as compared to controls. Baseline EF and PER were similar in subgroups HY and HO as well as in subgroups CY and CO, while PFR was particularly lower in the older hypertensive patients HO. After nicardipine, EF PER PFR significantly increased in groups H and C; EF and PER significantly increased in subgroups HY HO CY CO, while PFR had a significant increase in subgroups HY CY CO, but showed a not significant increase in subgroup HO. After nicardipine, the percentage changes of ventricular volume indexes were similar in the 4 subgroups; end diastolic volume was unchanged, end systolic volume had a clear decrease, stroke volume and cardiac output increased. The hypertensive patients had a damaged diastolic ventricular performance, as compared to the normal subjects, while EF was near to normal range in groups H and C.(ABSTRACT TRUNCATED AT 250 WORDS)