Comparative effects of captopril and nifedipine on diastolic and systolic cardiac function in elderly hypertensive patients.
Both nifedipine and captopril are effective in the treatment of systemic hypertension in the elderly, but their effects on cardiac function in this age group have not been evaluated. We studied the effects of acute oral administration of 20 mg nifedipine and 12.5 mg captopril on systolic and diastolic cardiac function, as evaluated by a radionuclide method, in 14 elderly hypertensives, mean age 73.4 +/- 3.9 years. The radionuclide studies were performed 1 h after ingestion of nifedipine and 1.5 h after captopril, on separate days. Nifedipine accelerated the heart rate whereas captopril slowed it. Nifedipine increased the ejection fraction by 2.6 +/- 14.6% but captopril increased it by 13 +/- 15.3%. Nifedipine reduced the left ventricular peak ejection rate by 4.8 +/- 21.7% whereas captopril increased it by 18 +/- 24.3%. Nifedipine increased the peak filling rate by 14.3 +/- 41.6% and captopril increased it by 27.6 +/- 32.6%. Nifedipine reduced the time to peak filling rate by 24.9 +/- 27.0%, but captopril reduced it by 68.8 +/- 59.6%. All these differences were statistically significant. Therefore, captopril improves some diastolic and systolic parameters of cardiac function more than nifedipine does. Other parameters are impaired by nifedipine but improved by captopril.
Marmor
A
A
Internal Medicine Department, Rebeca Ziv Medical Center, Safed, Israel.
Traub
Y
Y
Churi
A
A
Troshar
D
D
Schneeweiss
A
A
D000368:Aged; D002216:Captopril / Q000494:pharmacology*; D002986:Clinical Trials as Topic; D003971:Diastole / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects*; D009543:Nifedipine / Q000494:pharmacology*; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole / Q000187:drug effects*; D013997:Time Factors
D002216:Captopril; D009543:Nifedipine