Age and pathophysiology-oriented antihypertensive response to calcium antagonists.
Ageing is associated with pathophysiological adaptive changes in cardiovascular regulation including reduced baroreflex sensitivity and beta-adrenoceptor-mediated cardiac and renal responses. Accordingly, owing to such blunted counterregulation, older patients gain a greater fall in blood pressure for a given peripheral vasodilation, e.g., with a calcium antagonist. Such age-related efficacy may be helped by the calcium antagonist's renal and antialdosterone effects resulting in natriuresis. In open and double-blind treatment trials, calcium antagonists in monotherapy were more effective in reducing blood pressure to normal in older patients with hypertension and, for the same reasons, those with a low plasma renin activity or of black race; pretreatment blood pressure was another independent predictor. Age as well as renin and black race help to design antihypertensive treatment strategies with better blood pressure control and better well-being of the patient.
Bühler
F R
FR
Department of Research, University Hospital, Basel, Switzerland.
D000368:Aged; D000375:Aging / Q000502:physiology*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*
D002121:Calcium Channel Blockers