Related Experiment Videos
Comparison of nitrendipine and hydrochlorothiazide for systemic hypertension
Insights
This study compared nitrendipine and hydrochlorothiazide for hypertension treatment. Neither drug significantly changed left ventricular mass index, despite similar blood pressure reduction.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Systemic hypertension frequently causes left ventricular (LV) hypertrophy and dysfunction.
- Blood pressure (BP) reduction can regress LV hypertrophy, but antihypertensive drug choice may influence this outcome.
- Thiazide diuretics may worsen LV hypertrophy, while calcium channel blockers may improve or not affect it.
Purpose of the Study:
- To compare the effects of nitrendipine and hydrochlorothiazide on LV mass in hypertensive patients.
- To evaluate the impact of these antihypertensive agents on BP, plasma norepinephrine, and plasma renin activity.
Main Methods:
- An 8-week, double-blind study involving 18 hypertensive subjects aged 50 years or older.
- Participants received either nitrendipine (20 mg/day) or hydrochlorothiazide (50 mg/day).
- Measurements included BP, plasma norepinephrine, plasma renin activity, and left ventricular mass index.
Main Results:
- Both nitrendipine and hydrochlorothiazide significantly reduced BP.
- Plasma norepinephrine increased in both groups.
- Plasma renin activity increased significantly with hydrochlorothiazide but not with nitrendipine.
- Left ventricular mass index showed no significant change with either treatment.
Conclusions:
- Neither nitrendipine nor hydrochlorothiazide significantly altered left ventricular mass index in hypertensive patients over 8 weeks.
- Both drugs effectively lowered blood pressure.
- Hydrochlorothiazide significantly increased plasma renin activity, suggesting different neurohormonal effects compared to nitrendipine.
Abstract:
Left ventricular (LV) hypertrophy with associated LV systolic and diastolic dysfunction is frequently found in patients with systemic hypertension, and is multifactorial in origin. Although a reduction in blood pressure (BP) often results in regression of hypertrophy, the pharmacologic profiles of the antihypertensive agents used may determine the probability of such regression despite similar levels of BP reduction. Thiazide diuretic drugs may actually result in increased LV hypertrophy; calcium channel antagonists may cause regression or no change. The effects of treatment with nitrendipine (20 mg/day) or hydrochlorothiazide (50 mg/day) were compared in an 8-week, double-blind study of 18 hypertensive subjects aged 50 years or older. BP was significantly reduced (p less than 0.05) by both nitrendipine (from 161 +/- 29/102 +/- 4 to 145 +/- 24/92 +/- 7 mm Hg; mean +/- standard deviation) and hydrochlorothiazide (from 162 +/- 15/105 +/- 6 to 143 +/- 20/95 +/- 7 mm Hg). Plasma norepinephrine increased in the nitrendipine group, from 202 +/- 110 to 332 +/- 220 pg/ml at 8 weeks of therapy and in the hydrochlorothiazide group, from 147 +/- 130 to 313 +/- 277. Plasma renin activity changed from 3.2 +/- 2.4 to 3.5 +/- 2.1 during nitrendipine treatment, but from 2.1 +/- 2.1 to 10.5 +/- 10.8 ng angiotensin l/ml/90 min (p less than 0.05) during treatment with hydrochlorothiazide. Left ventricular mass index did not change significantly with either therapy.(ABSTRACT TRUNCATED AT 250 WORDS)