[Severe obstructive lung disease. The effect of the calcium antagonist isradipine on working capacity, pulmonary...

Several studies have reported beneficial haemodynamic effects of calcium antagonists in the treatment of patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension. Such effects include a decrease in pulmonary vascular resistance, an increase in cardiac output, and an increase in oxygen delivery, but the clinical implications of these effects remain uncertain. We therefore designed this first randomized, double-blind, placebo-controlled, long-term study to investigate the clinical effects of a calcium antagonist (isradipine) on patients with COPD. The aim of the study was to investigate the hypotheses that isradipine was able to increase working capacity and lung function, and decrease morbidity and mortality. During a 22-month observation of 52 patients with severe COPD no statistically significant differences between the isradipine group and the placebo group were found with regard to these parameters. It is concluded that the existing evidence does not justify the introduction of calcium antagonists as part of the routine treatment of COPD with pulmonary hypertension.