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Treatment of hypertension with dihydropyridine calcium antagonists and aspirin
P Tison1, L Ulicna, Z Jakubovska
1Department of Clinical Pharmacology, Institute of Preventive and Clinical Medicine, Bratislava, Slovak Republic.
Insights
This study found that dihydropyridine calcium antagonists effectively lower blood pressure in hypertensive patients. Adding aspirin did not impact blood pressure but influenced platelet activity differently with isradipine versus nitrendipine.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Essential hypertension is often associated with increased platelet activity.
- Dihydropyridine calcium antagonists are commonly used to manage hypertension.
- The interaction between calcium antagonists, aspirin, and platelet activity requires further investigation.
Purpose of the Study:
- To investigate the effects of isradipine and nitrendipine on blood pressure and platelet activity.
- To evaluate the impact of aspirin on the antihypertensive efficacy of dihydropyridines.
- To assess aspirin's effect on the 24-hour platelet activity profile in hypertensive patients.
Main Methods:
- A double-blind study involving patients with essential hypertension.
- Treatment with isradipine (2.5 mg/day) or nitrendipine (10 mg/day) for 8 weeks.
- Addition of aspirin (100 mg/day) for a further 8 weeks, with measurements of blood pressure, plasma beta-thromboglobulin (beta-TG), and platelet aggregation.
Main Results:
- Both isradipine and nitrendipine significantly reduced systolic and diastolic blood pressure.
- Aspirin addition did not alter the antihypertensive effects of either dihydropyridine.
- Dihydropyridines reduced elevated 24-hour plasma beta-TG and inhibited platelet aggregation; aspirin enhanced this effect with nitrendipine but partially reversed it with isradipine.
Conclusions:
- Dihydropyridine calcium antagonists effectively manage blood pressure and reduce platelet activity in hypertensive patients.
- Isradipine alone or nitrendipine combined with aspirin can prevent increased platelet activity.
- Low-dose aspirin (100 mg/day) does not compromise the blood pressure-lowering efficacy of these calcium antagonists.
Abstract:
The effects of dihydropyridine calcium antagonists on blood pressure and platelets, and the effects of aspirin on the circadian antihypertensive efficacy of dihydropyridines and on the 24-h platelet-activity profile, were the focus of a double-blind study. Patients with essential hypertension were treated for 8 weeks with either isradipine focus of double-blind study. Patients with essential hypertension were treated for 8 weeks with either isradipine (2.5 mg/day) or nitrendipine (10 mg/day). Aspirin (100 mg/day) was added to both treatment groups for a further 8 weeks. Measurements were taken after 4 weeks of placebo, after 8 weeks of dihydropyridine treatment, and after 8 weeks of treatment combined with aspirin. Plasma levels of beta-thromboglobulin (beta-TG) and platelet aggregation induced by serotonin were measured six times during 24 h. Both dihydropyridines significantly lowered systolic and diastolic blood pressure. The addition of aspirin to dihydropyridine treatment had no significant effects on systolic or diastolic blood pressure. Dihydropyridine treatment lowered the increased 24-h plasma beta-TG profile and inhibited platelet aggregability. Aspirin added to nitrendipine led to a further significant decrease in beta-TG levels whereas its addition to isradipine was accompanied by a partial increase in plasma beta-TG. It is concluded that increases in platelet activity in hypertensive patients can be prevented with either isradipine alone or nitrendipine plus aspirin. Aspirin in a daily dose of 100 mg does not affect the antihypertensive efficacy of calcium antagonists.