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Nicardipine hydrochloride in essential hypertension--a controlled study
Insights
Nicardipine effectively lowers blood pressure in patients with mild essential hypertension. This study shows nicardipine significantly reduced systolic and diastolic blood pressure compared to placebo over six weeks.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a widespread cardiovascular condition.
- Effective and well-tolerated antihypertensive agents are crucial for patient management.
Purpose of the Study:
- To evaluate the efficacy and tolerability of nicardipine as monotherapy for mild essential hypertension.
- To compare the effects of nicardipine versus placebo on blood pressure and plasma renin activity.
Main Methods:
- A double-blind, parallel-group study involving 50 patients with mild essential hypertension.
- Patients received either nicardipine 30 mg three times daily or placebo for 6 weeks.
- Blood pressure (supine and standing) and pulse rate were measured. Plasma renin activity (PRA) was also assessed.
Main Results:
- Nicardipine significantly reduced mean supine systolic/diastolic pressure by 21.2/15.0 mm Hg (P < 0.001) and standing systolic/diastolic pressure by 17.9/13.8 mm Hg (P < 0.001).
- Placebo resulted in nonsignificant changes in blood pressure.
- Nicardipine treatment led to a 52% increase in plasma renin activity (P < 0.01) without affecting pulse rate or causing tachyphylaxis.
- Adverse events were minor, with one case of muscle pain.
Conclusions:
- Nicardipine 30 mg three times daily is a well-tolerated and effective antihypertensive agent for mild essential hypertension.
- The drug demonstrates significant blood pressure-lowering effects compared to placebo.
- Increased plasma renin activity was observed but did not correlate with blood pressure reduction.
Abstract:
Fifty patients with mild essential (primary) hypertension entered a double-blind, parallel-group study with either nicardipine 30 mg three times daily or placebo, randomly assigned as monotherapy for 6 weeks. At the end of 6 weeks, the nicardipine-treated group had a statistically significant reduction in mean supine systolic/diastolic pressure of 21.2/15.0 mm Hg (P less than 0.001) compared with the nonsignificant reduction of 0.7/2.9 mm Hg in the placebo-treated group. The difference in mean response between the nicardipine- and placebo-treated groups was significant (P less than 0.001). In the nicardipine-treated group, the reduction in mean standing systolic/diastolic blood pressure, 17.9/13.8 mm Hg, was significant (P less than 0.001), whereas in the placebo-treated group the change was +3.0/-1.5 mm Hg. The difference between the two treatment groups was significant (P less than 0.001). In both treatment groups, changes in pulse rate were minor, and there was no evidence of tachyphylaxis occurring with nicardipine. Adverse experiences were minor in all cases except for one patient with muscle pain during treatment with nicardipine. Patients who received nicardipine showed a mean increase of 52% in plasma renin activity (PRA) after 6 weeks (P less than 0.01). Initial basal or stimulated PRA did not correlate with blood pressure reduction on nicardipine. Nicardipine 30 mg three times daily is a well-tolerated and effective antihypertensive agent.