Effects of sustained-release nicardipine on regression of left ventricular hypertrophy in systemic hypertension.
The effects of a sustained-release formulation of the calcium antagonist nicardipine on left ventricular (LV) mass, Doppler transmitral velocity profiles and plasma neurohumoral studies were analyzed in patients with mild to moderate systemic hypertension. A double-blind placebo control phase in 28 patients was carried out for 6 weeks with a subgroup of 13 subsequently entering an open-label long-term phase for 1 year. Nicardipine produced a significant decrease in systolic and diastolic pressure over the 6-week phase (158 +/- 15 to 142 +/- 9 mm Hg, and 100 +/- 5 to 89 +/- 9 mm Hg, respectively, both p less than 0.001). No significant differences in Doppler measures of mitral inflow or echocardiographic measures of LV function, wall thickness or mass were noted in the 6-week phase of the study. Although nicardipine increased both norepinephrine and renin values after the first dose, these levels had returned to baseline in most patients after 6 weeks. In addition, there was no evidence for stimulation of adrenomedullary activity because nicardipine had no effect on epinephrine or dopamine-B-hydroxylase levels at first dose or after 6 weeks. In the 13 patients treated for 1 year, systolic and diastolic pressure remained significantly decreased compared with pressure before therapy (135 +/- 9 vs 147 +/- 15 mm Hg, and 85 +/- 6 vs 97 +/- 9 mm Hg, both p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Dittrich
H C
HC
University of California, San Diego.
Adler
J
J
Ong
J
J
Reitman
M
M
Weber
M
M
Ziegler
M
M
D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D006332:Cardiomegaly / Q000097:blood / Q000503:physiopathology*; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009529:Nicardipine / Q000008:administration & dosage / Q000627:therapeutic use*; D009638:Norepinephrine / Q000097:blood; D010919:Placebos; D012083:Renin / Q000097:blood; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
D003692:Delayed-Action Preparations; D010919:Placebos; D000450:Aldosterone; D009529:Nicardipine; D012083:Renin; D009638:Norepinephrine; D004837:Epinephrine