Nicardipine retard in the therapy of elderly diabetic hypertensives: final report of observational study.
OBJECTIVE
An uncontrolled multicentre study was carried out in 10 hospitals of the Marche Region of central Italy, to evaluate the efficacy and tolerability of 40 mg nicardipine retard in elderly hypertensive patients with diabetes mellitus type II.


METHODS
The study lasted 6 months, single-blind for the first 3 months and open thereafter. The blood pressure criteria were 165 mmHg systolic and/or 95 mmHg diastolic measured at least three times consecutively in untreated patients or after 10 days of drug washout.


METHODS
All subjects had a proven diagnosis of diabetes mellitus type II and were greater than or equal to 65 years of age.


RESULTS
After the first 14 days of active treatment with nicardipine [corrected] retard at 40 mg/day, supine systolic blood pressure had fallen to 164.3 +/- 12.7 mmHg and diastolic to 92.2 +/- 7.3 mmHg (P less than 0.001). This first phase normalized blood pressure in 41.1% of patients. In 58.9% of patients the dose was doubled because goal blood pressure had not been achieved. After 4 weeks of therapy, mean supine systolic/diastolic values had fallen to 156.5 +/- 11.0/88.5 +/- 6.8 mmHg (P less than 0.001), and the proportion of patients requiring 80 mg/day had risen to 63.2%, with only 36.8% able to continue on the single dose. In 24.2% of the patients, monotherapy at 80 mg/day was not sufficient to normalize blood pressure and a second associated drug (enalapril, 10 mg/day) was administered. The mean blood pressure decrease induced by therapy was statistically significant from the second week of treatment (P less than 0.001). No significant variation in metabolic parameters was recorded during treatment.


CONCLUSIONS
Nicardipine [corrected] retard was effective and well tolerated in elderly subjects, both clinically and metabolically.
Antonicelli
R
R
Department of Cardiovascular Pathology and Hypertension, Italian National Research Centre on Aging (INRCA), Ancona.
Pagelli
P
P
Paciaroni
E
E
D000368:Aged; D000375:Aging / Q000502:physiology*; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D003692:Delayed-Action Preparations; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D009529:Nicardipine / Q000009:adverse effects / Q000627:therapeutic use*
D001786:Blood Glucose; D003692:Delayed-Action Preparations; D009529:Nicardipine