A multicenter, randomized, trial comparing urapidil and nitroglycerin in multifactor heart failure in the elderly

Area of Science:

• Cardiology
• Geriatrics
• Pharmacology

Background:

• Multifactor heart failure is a critical condition in elderly individuals, frequently co-occurring with hypertension and diabetes mellitus (DM).
• Current treatment strategies require evaluation for optimal patient outcomes.

Purpose of the Study:

• To compare the therapeutic benefits of urapidil (an α1-blocker) versus nitroglycerin (NG) in elderly patients with multifactor heart failure, hypertension, and DM.
• To assess the impact of these treatments on blood pressure, cardiac function, and metabolic parameters.

Main Methods:

• A randomized study involving 72 elderly patients with multifactor heart failure, hypertension, and DM.
• Patients were assigned to receive either urapidil or NG.
• Monitoring included blood pressure, heart rate, metabolic activity, and cardiovascular function tests.

Main Results:

• Urapidil significantly reduced systolic blood pressure compared to NG.
• Patients treated with urapidil exhibited lower N-terminal pro-B-type natriuretic peptide levels and improved ejection fraction and cardiac index.
• Both urapidil and NG decreased fasting plasma glucose, with no significant difference between the groups.

Conclusions:

• Urapidil demonstrated superior efficacy in lowering and stabilizing systolic blood pressure, reducing cardiac afterload, and enhancing cardiac function compared to NG.
• Both agents effectively reduced fasting plasma glucose in patients with diabetes.
• Urapidil presents a viable therapeutic option for managing multifactor heart failure in elderly patients with coexisting hypertension and DM.