title: Antihypertensive effects of parenteral nicardipine alone and in combination with captopril.
abstract: We studied the safety and efficacy of intravenous nicardipine alone and in combination with oral captopril. Sixteen patients with essential hypertension received a single oral dose of captopril, 50 mg, to be certain that excessive hypotension would not occur. Nicardipine was given intravenously as a 2 mg bolus, followed by an infusion at a rate designed to lower the supine diastolic blood pressure at least 10 mm Hg; then oral captopril, 50 mg, or placebo was given. The next week, nicardipine was again infused, but the alternate oral treatment was given. Intravenous nicardipine reduced blood pressure from 156 +/- 15/101 +/- 5 mm Hg (mean arterial blood pressure 120 +/- 6 mm Hg) to 140 +/- 11/88 +/- 4 mm Hg (mean arterial blood pressure 105 +/- 5 mm Hg). When captopril was added to nicardipine, the mean arterial blood pressure fell an additional 8 mm Hg but the heart rate did not increase. The combination of angiotensin-converting enzyme inhibition and calcium channel blockage produces additive antihypertensive effects without additional reflex tachycardia.
authors.forename: K A
authors.initials: KA
authors.lastname: Conrad
authors.forename: T C
authors.initials: TC
authors.lastname: Fagan
authors.forename: P
authors.initials: P
authors.lastname: Mayshar
authors.forename: T P
authors.initials: TP
authors.lastname: Davis
authors.forename: D G
authors.initials: DG
authors.lastname: Johnson
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007275:Injections, Intravenous; D008875:Middle Aged; D009529:Nicardipine / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D002216:Captopril; D009529:Nicardipine