Once daily nisoldipine in hypertension: cuff and ambulatory intra-arterial blood pressure.
Cuff blood pressure data has suggested that the calcium channel antagonist nisoldipine has full twenty four hour efficacy. To test this, 24 h ambulatory intra-arterial blood pressure monitoring was performed on 18 untreated hypertensive subjects (12 men, 6 women) (cuff blood pressure greater than 150/95 mm Hg) before and after chronic treatment with 10-20 mg oral nisoldipine taken daily at 08.00 h. Twelve patients completed the study, six being withdrawn, four because of side-effects. After baseline intra-arterial monitoring patients were started on 10 mg nisoldipine daily. Response was assessed by cuff pressures taken 24 h after dosing at fortnightly intervals, and if not controlled (less than 150/95 or at least 10 mm Hg reduction in diastolic BP) the dose was increased to 20 mg. All patients received at least six weeks' therapy before the second intra-arterial blood pressure monitoring. There was a slight but insignificant reduction in mean daytime heart rate of 3 beats.min-1. Mean significant reduction in daytime systolic and diastolic BP was 19 mm Hg and 13 mm Hg respectively but there was no significant mean night-time reduction. By comparison 8 out of 12 patients were apparently controlled more than 24 h post dose according to cuff pressures. This study suggests that this formulation of nisoldipine does not control blood pressure over a full 24-h period, and emphasises the importance of 24 h ambulatory monitoring in assesing the efficacy of once-daily antihypertensive agents.
Brigden
G
G
Department of Cardiology, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex, UK.
Heber
M
M
Caruana
M
M
Lahiri
A
A
Raftery
E B
EB
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods; D004305:Dose-Response Relationship, Drug; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015737:Nisoldipine / Q000008:administration & dosage* / Q000494:pharmacology
D015737:Nisoldipine