Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of spirapril and isradipine on blood pressure, urinary albumin excretion and sodium-volume homeostasis in hypertensive insulin-dependent diabetic patients with nephropathy were assessed. Fifteen Type 1 diabetic patients aged 28-53 years with a diabetes duration of 19-37 years were studied. All had hypertension and diabetic nephropathy with a urinary albumin excretion of more than 300 mg/24 h. After a single blind placebo treatment period of 4 weeks the patients were randomly assigned to treatment with the calcium antagonist isradipine SRO 5 mg once daily or the ACE inhibitor spirapril 6 mg once daily for 6 months in a double-blind design. Isradipine lowered ambulatory systolic blood pressure from 152 +/- 12 to 141 +/- 11 mmHg (p < 0.05) and ambulatory diastolic pressure from 91 +/- 9 to 86 +/- 8 mmHg (p < 0.05). The blood pressure lowering effect of spirapril was similar: 156 +/- 13 vs 143 +/- 11 mmHg (p < 0.01) and 90 +/- 4 vs 84 +/- 4 mmHg (p < 0.05). The fractional albumin clearance was unchanged on isradipine but decreased after 6 months treatment with spirapril with on average 20% (p < 0.05). Total body exchangeable sodium decreased on spirapril treatment: 2994 +/- 296 vs 2636 +/- 194 meq/1.73 m2 (p < 0.05) and extracellular volume tended to do so (p = 0.12). On isradipine treatment these parameters remained unchanged. In conclusion both isradipine and spirapril lowered blood pressure in patients with diabetic nephropathy. Only the ACE inhibitor had demonstrable beneficial effects on urinary albumin excretion rate and the sodium-volume expansion seen in these patients.
 ...
PMID:A comparison of spirapril and isradipine in patients with diabetic nephropathy and hypertension. 817

Certain classes of antihypertensive drugs, such as calcium antagonists, appear to have antiatherogenic properties, as shown in animal models. In these experimental models, only isradipine, a potent new dihydropyridine calcium antagonist, has shown an antiatherogenic effect in doses compatible with that recommended for antihypertensive treatment in humans. The Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS) was designed to assess the efficacy of isradipine (2.5 or 5.0 mg twice daily) compared with hydrochlorothiazide (HCTZ) in reducing the rate of progression of atherosclerotic plaque in carotid arteries, as measured by B-mode ultrasonography. MIDAS is the first clinical trial of hypertension designed to test the hypothesis that antihypertensive drug treatment may have a favourable effect on the progression of atherosclerosis in humans. MIDAS is a double-blind, randomized, controlled clinical trial involving 883 patients. The primary endpoint is the observed change in the rate of progression of the intimal-medial wall thickness of the carotid arteries, as measured quantitatively by B-mode ultrasonography over time. Changes in the mean maximum intimal-medial thickness (IMT) at 12 points in the carotid arteries (near and far walls of the common carotid, the carotid bifurcation, and internal carotid segments on both right and left sides of the neck) were measured over a 3-year period. At baseline, the mean age of the participants was 58.5 years. The mean systolic and diastolic blood pressures were, respectively, 149.8 and 96.5 mmHg. The mean duration of hypertension was 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:MIDAS: rationale, design and descriptive data of trial patients. The MIDAS Research Group. 820 95

The antihypertensive effect of isradipine was studied in 45 patients with mild-to-moderate hypertension (mean age 59 years) using casual and ambulatory 24-h blood pressure measurement. Patients were included into the study according to their casual blood pressure. Isradipine was started at a dose of 1.25 mg twice daily for 4 weeks, and increased to 2.5 mg twice daily if casual blood pressure was not normalized. If necessary, 3 mg of spirapril, a new angiotensin-converting enzyme (ACE) inhibitor, (n = 1) or 5 mg of pindolol (n = 1) was added. The active-treatment period lasted 24 weeks. At the end of the therapy, casual blood pressure was significantly decreased (p < 0.001) from 173/103 to 150/86 mmHg, and mean ambulatory blood pressure, from 146/87 to 140/83 mmHg (p < 0.05). When patients were divided into three groups according to initial whole-day ambulatory blood pressure values (group I: < 140/90 mmHg; group II: > or = 140/90 mmHg; group III: > or = 140/<90 mmHg), no effect of treatment was detected in group I. However, whole-day blood pressure fell significantly (p < 0.001) in group II (155/96 vs 143/88 mmHg) as did systolic blood pressure (p < 0.01) in group III (150/83 vs 142/81 mmHg), whereas diastolic blood pressure remained unchanged. Thus, ambulatory blood pressure measurement may be superior to casual measurement in the decision-making process to treat hypertension, avoiding not only the phenomenon of 'white-coat hypertension', but also ineffective treatment. This conclusion, however, should be confirmed by prospective studies.
 ...
PMID:Indication for antihypertensive treatment: superiority of ambulatory vs casual blood pressure measurement. 820 96

The aim of this study was to compare the tolerability and efficacy of isradipine and felodipine in the treatment of mild-moderate hypertension. After a 4 week placebo period, 143 patients entered a randomized, double-blind, multicentre study of 12 weeks duration. Patients received either isradipine (n = 72) or felodipine (n = 71) 2.5 mg twice daily. Doubling of this dose and the addition of enalapril (2.5 mg once daily) was permitted if DBP was > 90 mmHg at weeks 4 and 8, respectively. Isradipine monotherapy reduced BP from 165/104 +/- 13/6 mmHg at baseline to 149/91 +/- 14/10 mmHg at week 8 (p < 0.001), while felodipine alone reduced BP from 171/104 +/- 17/6 at baseline to 151/92 +/- 19/9 (p < 0.001). Following the addition of enalapril to 35% of patients in the isradipine group BP was further reduced to 144/88 +/- 13/8 mmHg at week 12 (p < 0.001). The addition of enalapril to 24% of the felodipine group further reduced BP to 150/92 +/- 19/9 mmHg at week 12 (p < 0.001). No differences in BP were found between the 2 groups while on monotherapy. However, the isradipine group had a significantly lower DBP than the felodipine group at the conclusion of the study (p = 0.008; 95% CI 0.7 to 6.9 mmHg). Similar incidences of headache, flushing, dizziness and tachycardia were reported in both groups. However, the incidence of ankle oedema was significantly lower in the isradipine group (p = 0.028). Overall, ankle oedema was reported more often by female patients and was not associated with an increase in weight.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:A comparison of isradipine and felodipine in Australian patients with hypertension: focus on ankle oedema. The Physician's Study Group. 820 14

Antihypertensive efficacy and tolerability of a 4-week treatment each with the modified release formulation of the calcium antagonist isradipine (5 mg; Lomir SRO, CAS 75695-93-1) were compared with those of nitrendipine (20 mg) (both with morning intake) in 51 patients with mild to moderate hypertension using a double-blind, intraindividual crossover study. Blood pressure was measured over 24 h at the end of a 2-week placebo phase and after both treatment phases by means of a continuous ambulatory recording device. Upon statistical evaluation of all patients with 3 complete 24-h profiles (n = 44) and combined analysis of data from same treatments the following 24-h mean values were obtained: blood pressure (syst./diast.) was lowered from 151/98 mmHg to 141/91 mmHg by isradipine retard (IS) and to 141/92 mmHg by nitrendipine (NI), whereas heart rate remained nearly unchanged (78 vs 79 beats/min on both therapies). The 24-h profiles differed significantly between placebo and both therapies, the profile as a whole was more even on IS. Starting from a day-time mean value (6:00 a.m.-10:00 p.m.) on placebo of 155/102 mmHg blood pressure was reduced by IS to 143/94 mmHg and by NI to 144/95 mmHg; the corresponding night-time mean values were; placebo 138/85 mmHg, IS 132/82 mmHg, NI 134/83 mmHg. If one compares the area under the blood pressure curves during the hours from 6 p.m. to 12 p.m. significant differences (2p = 0.0128) were found for systolic pressure and borderline significance (2p = 0.0668) for diastolic differences in favour of IS.
 ...
PMID:[Circadian antihypertensive action and tolerability of a sustained-release form of isradipine in an intra-individual comparison with nitrendipine]. 832 96

The effects of isradipine and metoprolol were studied on the brachial arteries of two groups of 14 patients with hypertension, 90 minutes after the first dose and after 3 months of treatment. Diameter (pulsed Doppler) and compliance (pulse-wave velocity) were measured and calculated in isobaric conditions by way of a model that allowed discrimination of the active intrinsic drug action. Isradipine increased measured and isobaric diameter during short-term (p < 0.05) and long-term administration (p < 0.05), whereas metoprolol did not change it. Active diameter effects were different between drugs during short-term administration (p < 0.05). Isaradipine increased measured and isobaric compliance during short-term (p < 0.05) and long-term administration (p < 0.05). Short-term administration of metoprolol decreased measured compliance (p < 0.01). Metoprolol decreased isobaric compliance during short-term (p < 0.01) and long-term (p < 0.05) administration. Active compliance effects were different between drugs during short- and long-term administration (p < 0.01). These arterial intrinsic drug effects, independent of the pressure-lowering influence, suggested different mechanisms, consisting of a large artery smooth muscle relaxation for isradipine and an isometric arterial constriction for metoprolol.
 ...
PMID:Intrinsic effect of antihypertensive treatment with isradipine and metoprolol on large artery geometric and elastic properties. 833 Apr 68

Isradipine is a dihydropyridine calcium antagonist used for the treatment of hypertension. It is highly selective for vascular smooth muscle, more than cardiac muscle, and thus, lowers systemic blood pressure by reducing peripheral vascular resistance. Isradipine has less negative exotropic effect than other available calcium antagonists, and generally does not affect cardiac output, stroke volume, or heart rate when used chronically to treat hypertension. This agent has been shown to reduce left ventricular mass in patients with left ventricular hypertrophy after 5 to 10 months of therapy, without affecting cardiac output. Unlike most other calcium antagonists, isradipine can be used safely in hypertensive patients with congestive heart failure because its use in blood pressure lowering dosages does not compromise pump function. Isradipine has antiischemic properties and, in animals, antiatherosclerotic properties. Generally, it is a safe, well-tolerated agent for the treatment of hypertension with primarily benign effects on the heart.
 ...
PMID:Cardiac effects of isradipine in patients with hypertension. 839 14

The objective of this study was to compare the tolerability of isradipine and felodipine in patients with mild-to-moderate hypertension. Following a 4-week placebo run-in, 143 patients entered a 12-week double-blind multicenter study. Patients were randomized to receive either isradipine (n = 72) or felodipine (n = 71) at a dose of 2.5 mg twice daily. Dose-doubling and the addition of enalapril (2.5 mg once daily) was permitted if diastolic blood pressure (DBP) was > 90 mm Hg at weeks 4 and 8, respectively. Isradipine reduced blood pressure from 165/104 +/- 13/6 mm Hg at baseline to 144/88 +/- 13/8 mm Hg at week 12 (P < .001) whereas felodipine reduced blood pressure from 171/104 +/- 17/6 mm Hg at baseline to 150/92 +/- 19/9 mm Hg at week 12 (P < .001). Similar incidences of headache, flushing, dizziness and tachycardia were reported in both groups. However, the incidence of ankle edema was significantly lower in the isradipine group (14% v 30%) (P = .028). It is concluded that isradipine represents a practical improvement over felodipine in the treatment of hypertension.
 ...
PMID:A multicenter comparison of isradipine and felodipine in the treatment of mild-to-moderate hypertension. The Physician's Study Group. 846 25

This multicenter, double-blind, randomized trial of 1 year's duration compared the safety and efficacy of isradipine, methyldopa, and placebo in 368 men, aged 40 to 65 years, with mild-to-moderate essential hypertension. Initial treatment with isradipine (1.25 mg twice daily), methyldopa (250 mg twice daily), or placebo was started after a wash-out and single-blind placebo period. If normotension [diastolic blood pressure (DBP) < 95 mm Hg] was not achieved, doses were doubled. If the maximum dose as monotherapy did not result in normotension, captopril (25 mg or, if necessary, 50 mg, once daily) was added to the treatments of the three patient groups. Despite the marked placebo effect during the first 2 weeks of treatment, monotherapy with isradipine resulted in a higher rate of normalization (more than 64%) compared with 50% in the methyldopa group and 36% in the placebo group. Adding captopril to the treatments of non-responders increased the rate of normalization to 90% in the isradipine group, 84% in the methyldopa group, and 75% in the placebo group. Twenty-one patients dropped-out and 70 patients discontinued the study, the majority because of a lack of efficacy and adverse reactions. The most common adverse reactions reported were cardiovascular and gastrointestinal complaints, headaches, and sleep and sexual disorders, mostly by patients taking methyldopa. Isradipine was well tolerated and the side-effects were minimal. These results indicate that isradipine is superior to methyldopa and, whether as monotherapy or in combination with captopril, highly effective and well tolerated in the treatment of mild-to-moderate hypertension.
 ...
PMID:A multicenter, double-blind, randomized, placebo-controlled study of isradipine and methyldopa as monotherapy or in combination with captopril in the treatment of hypertension. The LOMIR-MCT-IH Research Group. 846 28

The new slow-release oral formulation (SRO) of isradipine, a dihydropyridine calcium antagonist, was evaluated in 57 patients who had moderate-to-severe hypertension following a 2-week wash-out period and a 2-week placebo period. The angiotensin-converting enzyme (ACE) inhibitor spirapril, at a dose of 6 mg/day, was added to the treatment of those not responding to 5 mg/day isradipine SRO alone. After 4 weeks of active treatment, isradipine alone normalized blood pressure (diastolic blood pressure < or = 90 mm Hg) in 38 (66.6%) patients whereas a further 4 weeks of treatment with the combination of isradipine and spirapril led to normalization in 14 of the 19 (73.7%) patients with partial or nil blood pressure responses. Side-effects were mild and transient and were observed in nine patients (15.8%). Isradipine SRO is an effective and well-tolerated antihypertensive agent and combination with spirapril appears to enhance its efficacy without an increase in side-effects.
 ...
PMID:Efficacy of slow-release oral isradipine in moderate-to-severe hypertension with add-on spirapril. 846 34


<< Previous 1 2 3 4 5 6 7 8 9 Next >>