[Central and peripheral hemodynamic effects of nifedipine administered orally and sublingually in essential arterial...

The central and peripheral haemodynamic effects of the administration of 10 mg nifedipine sublingually in 6 patients with essential hypertension were compared with those observed after the administration of one 20 mg slow release tablet of nifedipine in 7 other hypertensive patients of the same age. The circulatory effects in the forearm were studied by pulsed Doppler velocimetry which allowed simultaneous measurement of the diameter of the brachial artery and of the velocity of blood flow. Both forms of administration significantly reduced the blood pressure by a significant reduction in total peripheral resistance. This reduction in total peripheral resistance was more significant (p less than 0.001 vs p less than 0.01) and more rapid with sublingual administration and was associated with a greater increase in heart rate and cardiac output. Both forms of administration induced an increase in brachial arterial blood flow due to a simultaneous increase in vessel calibre and velocity of blood flow. The results of this study show that both forms of administration act directly on the vessel wall of the arterioles and great arteries leading to a fall in blood pressure associated with an increase in peripheral blood flow. Sublingual nifedipine would seem to be the drug of choice for the treatment of hypertensive crises, whilst the slow release preparation with its lesser baroreflex stimulation would appear better suited for the long-germ treatment of essential hypertension.