Acute effect of nifedipine on blood pressure and left ventricular ejection fraction in severely hypertensive outpatients: predictive effects of acute therapy and prolonged efficacy when added to existing therapy.
Nifedipine is known to reduce blood pressure both acutely and chronically. However, the following questions remain to be answered: can nifedipine be given acutely and safety to patients with severe hypertension in an outpatient setting, would its efficacy be retained with long-term therapy, and is nifedipine safe in the presence of cardiomegaly? Nifedipine (10 mg capsule sublingually) was given to 46 outpatients with severe or apparently refractory hypertension; 19 were followed-up for 18 months and 18 for 24 months. Nifedipine reduced blood pressure acutely and safely in 43 of 46 outpatients (mean control diastolic pressure 137 mm Hg), irrespective of prior treatment regimen. Blood pressure levels after 2 to 24 months of twice daily oral nifedipine (10 mg) were similar to 20-minutes levels, showing that tolerance did not occur. In a separate series of 37 patients, who had radiologic cardiomegaly in addition to hypertension, the control ejection fraction was 62%. Nifedipine, when used acutely, slightly increased the ejection fraction to 65% (p less than 0.005). Our studies show that in outpatients with severe hypertension, sublingual nifedipine is an antihypertensive agent which acts swiftly and safely, without causing a decrease in the ejection fraction when it is used for acute blood pressure reduction, and that subsequent therapy with oral nifedipine results in a predictive long-term hypotensive effect.
Jennings
A A
AA
Jee
L D
LD
Smith
J A
JA
Commerford
P J
PJ
Opie
L H
LH
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D006332:Cardiomegaly / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D007024:Hypotension, Orthostatic / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000494:pharmacology* / Q000627:therapeutic use; D011224:Prazosin / Q000627:therapeutic use; D013318:Stroke Volume / Q000187:drug effects*; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D009543:Nifedipine; D011224:Prazosin