Clinical use of nifedipine GITS in the treatment of hypertension: an overview.
Given the major role of elevated blood pressure in the pathogenesis of both stroke and coronary heart disease, one of the biggest challenges facing public health authorities and medical practitioners is the control of hypertension worldwide, both in individual patients and at the population level. The prevalence of hypertension increases with age and is nearly 60% in people aged 65 - 74 years. With increasing age, polymorbidity and polypharmacy usually contribute to an increasingly complex approach to manage the respective clinical conditions, including the treatment of hypertension. All subgroups of calcium channel blockers are effective and well-tolerated in lowering blood pressure. They are of demonstrated benefit for the prevention of stroke in elderly patients with systolic hypertension. Calcium channel blockers are particularly recommended for elderly patients with systolic hypertension and for black patients. The nifedipine gastrointestinal therapeutic system (GITS) formulation provides a once-daily dosing regimen with a continuous and slow release of the drug, resulting in a smooth plasma concentration/time profile. The INSIGHT study established that nifedipine GITS decreased mortality and morbidity at the same level as standard diuretic treatment in hypertensive patients with additional risk factors. A subgroup analysis showed that the long-term protective effects of nifedipine GITS extended to hypertensive patients with diabetes mellitus and with previous myocardial infarction. Two substudies of INSIGHT showed that nifedipine slowed the progression of atherosclerosis in carotid arteries (intima-media thickness) and coronary arteries (coronary calcium) as compared to diuretic.
Simon
Alain
A
Centre de Médecine Préventive Cardiovasculaire, Hôpital Broussais, 96 Rue Didot, 75674 Paris, France. alain.simon@brs.ap-hop-paris.fr
Levenson
Jaime
J
D003692:Delayed-Action Preparations / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D009543:Nifedipine / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics
D003692:Delayed-Action Preparations; D009543:Nifedipine