Calcium Antagonists: Interactions in Hypertension

Salvetti, Antonio; Pedrinelli, Roberto; Magagna, Armando; Stornello, Michele; Scapellato, L

doi:10.1159/000167228

Cited by 9 publications

(8 citation statements)

References 11 publications

(14 reference statements)

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“…It is suggested that the increased angiotensin II synthesis does not affect the BP control with nifedipine, since vasodilatory effect of nifedipine is considerable. Sulindac did not affect the control of hypertension by Ca antagonist, consistent with the previous reports (Salvetti et al 1986 ;Baez et al 1987). Diclofenac sodium also did not interfered with the BP control.…”

Section: Discussionsupporting

confidence: 92%

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No Adverse Effect of Non-Steroidal Anti-Inflammatory Drugs, Sulindac and Diclofenac Sodium, on Blood Pressure Control with a Calcium Antagonist, Nifedipine, in Elderly Hypertensive Patients.

Takeuchi¹,

Abe

Yasujima³

et al. 1991

Tohoku J. Exp. Med.

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Section: Discussionsupporting

confidence: 92%

“…Moreover, the antihypertensive effect of nifedipine was not affected by indomethacin (Salvetti et al 1986). Thus, the effect of NSAIDs on the hypertension treatment with Ca antagonist appears to be controversial.…”

mentioning

confidence: 97%

No Adverse Effect of Non-Steroidal Anti-Inflammatory Drugs, Sulindac and Diclofenac Sodium, on Blood Pressure Control with a Calcium Antagonist, Nifedipine, in Elderly Hypertensive Patients.

Takeuchi¹,

Abe

Yasujima³

et al. 1991

Tohoku J. Exp. Med.

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“…A lack of change in blood pressure after 1 week of treatment with indomethacin in patients receiving nifedipine was regarded as evidence that the prostaglandin system is not involved in the vasodilatory and antihypertensive activity of nifedipine [19].…”

Section: Amlodipine + Placebomentioning

confidence: 99%

Amlodipine and haemodynamic effects of cyclo‐oxygenase inhibition.

Minuz

Pancera

Ribul

et al. 1995

Brit J Clinical Pharma

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(-216.1 ng 24 h-1, 95% CI -276.5, -155.8; P < 0.001), together with an increase in systolic (+7.8 mm Hg, 95% CI +3.1, +12.3; P < 0.01) and diastolic (+3.9 mm Hg, 95% CI +1.2, +6.6; P < 0.01) blood pressure; it had no significant effect on regional vascular resistances (+4.7 mm Hg ml-l s, 95% CI -5.6, +15.0). Effects of ibuprofen on renal prostanoid synthesis were less marked, and there was no change in indices of renal function or hydro-electrolytic balance. 5 The haemodynamic effects of amlodipine may be partially antagonised by ibuprofen, which mainly determines inhibition of extrarenal prostanoid synthesis. It is suggested that this antagonism is attributable not so much to a direct effect of the calcium antagonist on prostacyclin synthesis as to an alteration in vascular tone, dependent on prostacyclin and perhaps other vasodilatory prostanoids.

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“…Salvetti et al [15] reported that indomethacin when added to nifedipine in a placebo controlled crossover study in 10 subjects did not cause any significant change in blood pressure control. However indomethacin was administered for only one week which may have been too short for the interaction to be manifest.…”

Section: Discussionmentioning

confidence: 99%

Effect of Indomethacin on Blood Pressure Control during Treatment with Nitrendipine

et al. 1995

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This study tested the hypothesis that treatment with a nonsteroidal anti-inflammatory drug will not alter the hypotensive effect of a dihydropyridine calcium channel antagonist. Fifteen essential hypertensives (ages 58-80 years) had a supine diastolic blood pressure (DBP) < 100 mmHg after 4 weeks monotherapy with nitrendipine 5-20 mg twice daily. They entered a double-blind randomised crossover study in which the addition of indomethacin 25 mg three times daily was compared with placebo in treatment phases each of 4 weeks duration. Subjects were seen weekly and measurements in the last 2 weeks of each phase were compared. Supine blood pressure (mean +/- SE) was higher in the indomethacin phase (158 +/- 4/80 +/- 2) than in the placebo phase (154 +/- 4/76 +/- 3) (p < 0.01 for DBP). In 6/15 (40%) of subjects the increase in supine diastolic blood pressure with indomethacin was > 5 mmHg. Plasma urea was also increased in the indomethacin phase: 7.6 +/- 0.6 mmol/l compared with placebo: 6.3 +/- 0.5 mmol/l (p < 0.001). The study has demonstrated that concurrent treatment with the NSAID indomethacin impairs the blood pressure lowering effect of the dihydropyridine calcium channel antagonist nitrendipine. This increase in blood pressure with indomethacin in subjects treated with nitrendipine may represent either an independent pressor effect of indomethacin or a reduced vasodilator prostanoid contribution to the hypotensive effect of nitrendipine. This blood pressure increase may be sufficient to interfere significantly with clinical blood pressure control in some subjects.

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Calcium Antagonists: Interactions in Hypertension

Cited by 9 publications

References 11 publications

No Adverse Effect of Non-Steroidal Anti-Inflammatory Drugs, Sulindac and Diclofenac Sodium, on Blood Pressure Control with a Calcium Antagonist, Nifedipine, in Elderly Hypertensive Patients.

No Adverse Effect of Non-Steroidal Anti-Inflammatory Drugs, Sulindac and Diclofenac Sodium, on Blood Pressure Control with a Calcium Antagonist, Nifedipine, in Elderly Hypertensive Patients.

Amlodipine and haemodynamic effects of cyclo‐oxygenase inhibition.

Effect of Indomethacin on Blood Pressure Control during Treatment with Nitrendipine

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