One year experience of elderly hypertensive patients with isradipine therapy

Area of Science:

• Cardiology
• Geriatrics
• Pharmacology

Background:

• Essential hypertension is a prevalent condition in the elderly population.
• Long-term treatment options for hypertension in older adults require evaluation for safety and efficacy.
• Dihydropyridine calcium channel blockers are a common class of antihypertensive medications.

Purpose of the Study:

• To evaluate the long-term (one year) safety and efficacy of isradipine in elderly patients with essential hypertension.
• To assess the tolerability and blood pressure control achieved with isradipine monotherapy or in combination with hydrochlorothiazide.
• To determine the optimal dosing regimen for isradipine in this patient population.

Main Methods:

• Open-label, continuation study of patients who completed a 3-month double-blind trial comparing isradipine to hydrochlorothiazide.
• Inclusion criteria: age >= 60 years, sitting diastolic blood pressure (DBP) 95-120 mmHg.
• Isradipine titration (5-15 mg once daily or 2.5-10 mg twice daily) to achieve DBP <= 90 mmHg; hydrochlorothiazide (12.5-50 mg once daily) could be added.

Main Results:

• 136 patients completed the one-year study.
• Isradipine monotherapy was used in 114 patients (84%), with a mean dose of 9.7 mg/day.
• Significant reduction in DBP (mean change -19 mmHg) and SBP observed, similar across age groups and races.
• 94% of patients on isradipine monotherapy achieved blood pressure control.
• 16% of patients withdrew; 7% due to adverse reactions (headache, pedal edema).

Conclusions:

• Isradipine is a well-tolerated, safe, and effective agent for long-term blood pressure control in elderly patients with essential hypertension.
• The drug demonstrated sustained efficacy in reducing both systolic and diastolic blood pressure.
• Adverse events were generally mild and infrequent, supporting its use in this demographic.