Related Experiment Videos
Prolonged calcium channel blocker therapy of hypertension
1Department of Medicine, Veterans Administration Medical Center, Long Beach, California 90822.
Insights
Nitrendipine, a dihydropyridine calcium channel blocker, effectively lowered blood pressure in hypertensive patients. Combination therapy with propranolol or hydrochlorothiazide further improved outcomes for non-responders.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension remains a significant global health concern.
- Dihydropyridine calcium channel blockers are a cornerstone in antihypertensive therapy.
Purpose of the Study:
- To evaluate the efficacy and safety of nitrendipine in a large cohort of hypertensive patients.
- To assess the effectiveness of nitrendipine monotherapy and combination therapy.
Main Methods:
- A multicenter study involving 329 hypertensive patients.
- Dose titration of nitrendipine (5 mg to 20 mg twice daily) based on blood pressure response.
- Assessment of blood pressure, body weight, and heart rate over one year.
- Addition of propranolol or hydrochlorothiazide for patients with inadequate response.
Main Results:
- 44% of patients achieved goal blood pressure (supine diastolic < 90 mm Hg) with nitrendipine titration.
- Nitrendipine monotherapy maintained goal blood pressure in 155 patients.
- Combination therapy with propranolol or hydrochlorothiazide further reduced blood pressure in non-responders.
Conclusions:
- Nitrendipine is an effective antihypertensive agent for a significant proportion of patients.
- Combination therapy can enhance blood pressure control in patients not adequately managed with nitrendipine alone.
- Nitrendipine demonstrated a favorable safety profile with no significant changes in body weight or heart rate.
Abstract:
The dihydropyridine calcium channel blocker nitrendipine was studied in 329 hypertensive patients at 12 separate centers for periods of 1 year or more. Patients with untreated supine diastolic blood pressures greater than 90 mm Hg were given nitrendipine 5 mg twice daily for 1 week; if the goal blood pressure was not achieved (supine diastolic blood pressure less than 90 mm Hg with a fall of at least 10 mm Hg), the dose was doubled, and if necessary it was doubled again after an additional week. By the end of titration, the goal blood pressure had been achieved in 138 patients (44%). During the subsequent 11 months of study, 155 patients continued to take nitrendipine alone; their posttitration supine diastolic blood pressure was 85 +/- 7 mm Hg, and at the end of the 1 year study it was 84 +/- 6 mm Hg. There were no significant changes in body weight or in heart rate. At their discretion, investigators could add other antihypertensive agents in patients not responding adequately to nitrendipine alone. In 41 patients with a supine diastolic blood pressure of 95 +/- 9 mm Hg after initial titration, propranolol was added to the nitrendipine and decreased the supine diastolic blood pressure to 88 +/- 8 mm Hg by the end of the study; and in another 76 patients with a posttitration supine diastolic blood pressure of 92 +/- 7 mm Hg, the addition of hydrochlorothiazide decreased the supine diastolic blood pressure to 86 +/- 7 mm Hg by the end of the study.(ABSTRACT TRUNCATED AT 250 WORDS)