Nifedipine tablets for systemic hypertension: A study using continuous ambulatory intraarterial recording

Hornung, R. S.; Gould, Brian A.; Jones, R. I.; Sonecha, Tansukh; Raftery, Edward B.

doi:10.1016/0002-9149(83)90306-5

Cited by 77 publications

(8 citation statements)

References 19 publications

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“…They also found that blood pressure reduction was greatest 2 h post-dose although peak plasma concentrations are usually obtained 3 to 5 h post-dose (Hasselgren et al, 1987). Continuous ambulatory intra-arterial recording of blood pressure during nifedipine treatment indicate that nifedipine 20-60 mg twice-daily can provide 24 h control of blood pressure (Hornung et al, 1983). These data are not inconsistent with the present study since it is quite possible for blood pressure to remain below some chosen criterion of blood pressure control while at the same time showing variation in the degree of blood pressure reduction during the day.…”

Section: Discussionsupporting

confidence: 57%

Control of blood pressure in hypertensive patients with felodipine extended release or nifedipine retard.

Littler

1990

Brit J Clinical Pharma

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1 This multicentre hospital study compared the antihypertensive efficacy and the tolerability of once daily felodipine extended release (ER) with twice daily nifedipine retard (R) in hypertensive patients inadequately controlled on metoprolol monotherapy. 2 One hundred patients, aged 20-70 years, whose seated diastolic blood pressure was 100-115 mmHg after 4 to 6 weeks of metoprolol (200 mg day-) monotherapy, were randomised, double-blind, to receive felodipine ER 10 mg once daily or nifedipine R 20 mg twice daily for 8 weeks. The dosage of felodipine or nifedipine was doubled if seated diastolic blood pressure exceeded 95 mmHg, 2 or 4 weeks after randomisation. Metoprolol 200 mg once daily was taken throughout the trial. 3 Fifty-one patients received felodipine ER and 49 nifedipine R; 46 and 45 respectively completed the 8 week trial. About half of patients on each treatment needed the higher dose. The baseline characteristics of the felodipine and nifedipine groups were generally well balanced.4 Seated diastolic blood pressure was reduced by 17 mmHg for felodipine (24 h postdose) and by 9 mmHg for nifedipine (12 h post-dose), a difference between treatments of 8 mmHg (95% confidence interval 5 to 12 mmHg, P < 0.0001). The attained blood pressures at the end of the study (felodipine 90 ± 10, mmHg, mean ± s.d.; nifedipine 95 + 10) were also significantly different (95% confidence interval for the S mmHg difference, -9 to -1 mmHg, P < 0.02). 5 In contrast, 3 h post-dose, the reduction in diastolic blood pressure was similar for both drugs; felodipine 17 mmHg, nifedipine 14 mmHg (difference 3 mmHg, 95% confidence interval -3 to +7 mmHg, P > 0.2). The attained blood pressures were also similar (felodipine 81 ± 9; nifedipine 83 ± 8 mmHg). 6 The pattern and prevalence of adverse events were similar for the two drugs, with the most common adverse events being ankle oedema, flushing and headache. In response to a questionnaire, 'vasodilator' adverse events were reported by 31% of patients on metoprolol alone and increased to over 50% during treatment with the calcium antagonists. 7 In this trial felodipine ER produced a greater reduction in blood pressure than nifedipine R when blood pressure was measured at the end of the dose interval. Felodipine had a more even effect at 3 and 24 h post-dose than did nifedipine 3 and 12 h post-dose.

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Section: Discussionsupporting

confidence: 57%

Control of blood pressure in hypertensive patients with felodipine extended release or nifedipine retard.

Littler

1990

Brit J Clinical Pharma

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“…In a similar study, nifedipine and diltiazem used as antihypertensive agents were both shown to be effective in lowering blood pressure [23]. In a study of ambulatory patients in whom 24-hour blood pressure monitoring was performed, nifedipine therapy was judged consistently effective; long-term follow-up of these patients confirmed that drug action was sustained [24].…”

Section: Results O F Studies Examining Monotherapymentioning

confidence: 97%

Calcium Channel Blockers in Systemic Hypertension

Frishman

1987

Am J Nephrol

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Calcium channel blockers selectively inhibit transmembrane flux of calcium in excitable tissue. Their ability to block calcium-mediated electromechanical coupling in contractile tissue produces peripheral vasodilation and has led to their clinical use in patients with systemic hypertension. The drugs appear to be well tolerated and have excellent safety profiles. Sustained-release preparations allow the drugs to be used once or twice daily. The calcium channel blockers will play an important role in the management of patients with mild, moderate, and severe hypertension when used as monotherapy or when combined with other antihypertensive medications. They can also be used in patients with concomitant diseases, such as angina pectoris and arrhythmia.

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“…Experience with the calcium-channel blockers nifedipine, verapamil, and diltiazem has shown them to be safe and effective in the treatment of systemic hypertension [5][6][7]. Ill this multicenter randomized, double-blind clinical study, isradipine in doses of 2.5-10 mg bid was safe and effective in the treatment of patients with mild to moderate hypertension.…”

Section: Discussionmentioning

confidence: 99%

A multicenter comparison of isradipine and prazosin for treatment of essential hypertension

Swartz

Gonasun²,

Thadani

1990

Cardiovasc Drug Ther

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Isradipine is a dihydropyridine calcium-entry blocking agent with pronounced vasodilator activity and no significant cardiac effects at clinical doses, a desirable profile for an antihypertensive drug. Prazosin, a post-junctional alpha-adrenoceptor blocking agent, may produce a similar hemodynamic pattern. Therefore, we compared the effects of isradipine (2.5-10 mg bid) with those of prazosin (2-8 mg bid) in 83 patients with established essential hypertension, using a randomized, double-blind, parallel-group design. Patients received a placebo for 3-5 weeks, then either isradipine or prazosin over a 6-week titration period, followed by a 4-week plateau phase. During the plateau period, isradipine therapy lowered sitting blood pressure more effectively than did the administration of prazosin: Mean systolic BP fell 16.7 versus 8.1 mmHg (p less than 0.001) and mean diastolic BP was reduced 15.6 versus 12.6 mmHg (p less than 0.01). In the dosing range used (while also noting that prazosin is occasionally titrated up to doses of 30 mg qd), 83% of isradipine-treated patients had at least a 10 mmHg reduction in diastolic BP, compared with 64% of prazosin-treated patients (p = 0.05, FET). Tachyphylaxis did not occur with either drug. The rate of occurrence of side effects was similar in both treatment groups; the most common adverse event seen with isradipine was headache (20%) and with prazosin, dizziness (19%).

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Nifedipine tablets for systemic hypertension: A study using continuous ambulatory intraarterial recording

Cited by 77 publications

References 19 publications

Control of blood pressure in hypertensive patients with felodipine extended release or nifedipine retard.

Control of blood pressure in hypertensive patients with felodipine extended release or nifedipine retard.

Calcium Channel Blockers in Systemic Hypertension

A multicenter comparison of isradipine and prazosin for treatment of essential hypertension

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