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Effects of sustained-release isradipine on left ventricular anatomy and function in systemic hypertension
M Bignotti1, G Gaudio, G Gorini
1Department of Internal Medicine and Medical Therapy, University of Pavia, Ospedale di Circolo, Varese, Italy.
Insights
Sustained-release isradipine effectively lowers blood pressure (BP) in hypertensive patients. This treatment also reduces left ventricular (LV) mass and improves diastolic function, without impacting systolic function.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Hypertension often leads to left ventricular hypertrophy (LVH), a risk factor for cardiovascular events.
- Assessing the impact of antihypertensive medications on cardiac structure and function is crucial.
Purpose of the Study:
- To evaluate the effects of sustained-release isradipine on left ventricular (LV) morphology and function in hypertensive patients with LVH.
- To determine if isradipine treatment improves diastolic function and reduces LV mass.
Main Methods:
- Digitized M-mode echocardiograms and 24-hour ambulatory blood pressure (BP) monitoring were used.
- 12 hypertensive patients with LVH received 6 months of sustained-release isradipine (5 mg daily) after a 2-week placebo period.
Main Results:
- Sustained-release isradipine significantly reduced BP without affecting heart rate.
- LV mass decreased in all patients, and LV diastolic function improved significantly.
- LV systolic function remained unchanged, and diastolic function normalized in most patients with initial impairment.
Conclusions:
- Once-daily sustained-release isradipine is an effective antihypertensive therapy.
- The drug promotes regression of LV hypertrophy and enhances diastolic function, with no adverse effects on systolic function.
Abstract:
With use of digitized M-mode echocardiograms and 24-hour noninvasive ambulatory blood pressure (BP) monitoring, the effects of chronic treatment with sustained-release isradipine on left ventricular (LV) morphology and function in hypertensive patients were evaluated. We selected 12 patients with LV hypertrophy and normal LV diastolic diameter. Echocardiograms and 24-hour BP monitoring were performed after 2 weeks of placebo and after 6 months of oral treatment with sustained-release isradipine (5 mg once daily). Therapy significantly reduced BP without changes in heart rate. LV mass decreased in all patients and peak lengthening rate of LV diameter, index of diastolic function, increased in all, with normalization in 7 of the 9 with basal diastolic impairment. Peak shortening rate of LV diameter, index of systolic function, was normal in all patients at basal evaluation and did not change after therapy. Reduction in LV mass significantly (p < 0.05) correlated with the decrease in average 24-hour and daytime systolic and diastolic BP. Sustained-release isradipine administered once daily is an effective antihypertensive agent; the drug also induces regression of LV hypertrophy, with significant improvement in LV diastolic function and no deterioration in systolic function.