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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The regression of left ventricular hypertrophy (LVH) is considered a desirable goal of antihypertensive treatment. Isradipine was used as first-line antihypertensive treatment in 15 patients who had mild-to-moderate hypertension and LVH, and who were studied before and after 6 months of treatment. Left ventricular mass and function were assessed by Doppler echocardiography. Systolic and diastolic blood pressure were reduced from 161 +/- 14 mm Hg and 103 +/- 3 mm Hg to 136 +/- 8 mm Hg and 87 +/- 6 mm Hg, respectively (P < .001). The interventricular septal thickness was reduced by 11.9% (P < .001), posterior wall thickness by 11.1% (P < .001), left ventricular end-diastolic diameter by 2%, and left ventricular mass index by 17% (P < .02). In conclusion, 6 months of antihypertensive treatment of mild-to-moderate hypertension with isradipine achieves a significant regression (17%) of LVH.
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PMID:Regression of left ventricular hypertrophy with isradipine in previously untreated hypertensive patients. 846 37

Isradipine is a new dihydropyridine-derived calcium antagonist. It possesses marked vascular selectivity, resulting in a powerful vasodilating action, whereas, in practical terms, it is devoid of cardiac effects. The usefulness of isradipine in the treatment of arterial hypertension is well documented, both when used as single-drug treatment and in combination with other agents, particularly, beta-blockers. Isradipine is well tolerated and does not negatively affect quality of life or capacity for physical exercise. It does not cause metabolic disturbances and, apart from the typical dihydropyridine-type vascular side-effects, specifically, flushing and ankle oedema, there are no specific adverse effects. Even ankle oedema is apparently relatively rare with this compound. Studies in animal models show that isradipine has a potent anti-atherosclerotic effect, and a brain tissue-preserving effect after experimental stroke, in doses that are relevant for antihypertensive treatment. If such results can be confirmed in humans, they will undoubtedly be of great clinical importance.
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PMID:Isradipine: a profile in essential hypertension. 848 May 3

The significant effects of isradipine in producing arterial vasodilation and mild negative chronotropic effects without significant negative inotropic effects suggests that this agent should provide excellent antihypertensive efficacy in the treatment of perioperative hypertension. Isradipine may prove to be a safe antihypertensive treatment in patients with impaired ventricular function (cardiac failure), impaired myocardial perfusion (ischaemia), and in cases of selected conduction abnormalities or arrhythmias. The demonstration that its effects are limited to vascular resistance rather than vascular capacitance is an important distinguishing feature of isradipine compared with other antihypertensive agents. Finally, the potential application of this dihydropyridine calcium antagonist for cytoprotection and its effects on atherosclerosis remain exciting therapeutic prospects.
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PMID:Haemodynamics and tissue specificity with isradipine. 848 May 4

The authors demonstrated that isradipine reduces the blood pressure assessed at rest in patients with mild to medium severe hypertension. The antihypertensive action was enhanced by administration of beta-blockers. In a loading test the pressor response to strain was reduced in particular as regards diastolic pressure; from this in may be concluded indirectly that a vasodilatating effect is involved. The authors recorded a rise of plasma renin activity which may be associated with previous vasodilatation. Parameters of lipid metabolism were influenced by isradipine. The indifference of isradipine as regards the effect on functions indicated by biochemical screening was again confirmed in the present investigation. The undesirable effects typical for calcium antagonists were manifested in a very small percentage of the investigated subjects and in a small number of repeated examinations. The reason for discontinuation of treatment in one patient was an effects which does not threaten the patient (flush). Isradipine is an effective antihypertensive drug with very good tolerance.
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PMID:[The antihypertensive effect of isradipine and additional pharmacodynamic effects]. 850 74

Calcium entry through L-type calcium channels is essential for contraction of both arterial smooth muscle and the myocardium, and is important in cardiac conduction. First-generation calcium entry blockers lack or have a modest degree of vascular selectivity and inhibit cardiac function at doses producing therapeutic arterial dilatation. Such agents may cause deterioration in patients with left ventricular dysfunction, and their combination with a beta-adrenergic blocker may adversely affect cardiac contractility and conduction. Development of newer agents has focused on obtaining a higher degree of vascular selectivity. Felodipine is a highly vascular selective calcium entry blocker, with a vascular selectivity ratio greater than 100, as shown experimentally. Isradipine and nicardipine are also vascularly selective calcium entry blockers. Hemodynamic studies in patients with hypertension, coronary artery disease, congestive heart failure, or in patients receiving beta-adrenergic blockade, show that felodipine can produce profound arteriolar dilatation without the negative effects of left ventricular systolic performance. Furthermore, felodipine alone or when added to a beta-adrenergic blocker does not interfere with cardiac conduction. The primary mechanism that accounts for the efficacy of dihydropyridine calcium entry blockers in hypertension and angina pectoris is arterial dilation, whereas nondihydropyridines may also derive part of their effect from inhibition of cardiac performance. As some of these patients, most commonly the elderly, have concomitant left ventricular dysfunction, it should be advantageous to avoid myocardial depression in the treatment of their primary disease. Preliminary studies in patients with heart failure indicate that felodipine and amlopidine may improve hemodynamics, reduce neurohormonal activation, and increase exercise tolerance, but final conclusions must await the randomized clinical trials now underway.
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PMID:Vascular selective calcium entry blockers in the treatment of cardiovascular disorders: focus on felodipine. 857 48

The authors assessed the efficacy and safety of intravenous lomir used to treat arterial hypertension in 10 coronary patients early after aortocoronary shunting. The following parameters were monitored: systolic, diastolic, and mean arterial pressure, ECG, pressure in the pulmonary artery, blood gases, and minute volume obtained by thermodilution. Intravenous lomir was found to be a highly effective hypotensive agent in patients in the early periods after aortocoronary shunting, well tolerated by the patients, the infusions being easy to monitor and involving virtually no side effects. Lomir improved the coronary bloodstream, virtually did not influence the heart rate, atrioventricular conduction, and pumping function of the heart.
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PMID:[An assessment of the efficacy of Lomir in treating hypertension in patients in the early period after aortocoronary bypass operations]. 868 46

The aim of the present study was to evaluate efficacy on blood pressure values and metabolic tolerability of Isradipine, which was given to 15 mild hypertensive non diabetic subjects (average age 63.8 +/- 10.9 years), at the dosage of 5 mg once a day. Plasma lipids concentrations and oral glucose tolerance test (OGGT) with plasma insulin assay were carrid out before, after one and three months of therapy. The statistical analysis was done using the Student's t test for paired data. Isradipine showed a good efficacy on lowering high blood pressure. In no patients the drug induced impaired glucose tolerance. Isradipine had contrasting, but not statistically significant effects on lipid concentrations, namely, decrease of triglycerides, increased of any form of cholesterol (total, HDL, LDL), apoproteins and lipoprotein(a).
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PMID:[Metabolic tolerance of isradipine. Evaluation after three months of therapy]. 872 Mar 49

Antihypertensive Efficacy and Tolerability of Isradipine in Patients with Severe Hypertension/Results of an open multicenter study. In this open multicentre study 55 patients (mean age 51.2 years) with severe hypertension (diastolic blood pressure > 115 mmHg) were treated for seven weeks with the calcium antagonist of the dihydropyridine type isradipine (CAS 75695-93-1, Lomir). If necessary, metoprolol or enalapril were added to the regimen. Before inclusion into the active treatment phase, responsiveness of the patients to a single administration of isradipine (5 mg) was compared with placebo. Preexisting antihypertensive therapy (18 patients) was to be maintained during the study period. Blood pressure was recorded with an automatic device. During the 7-week period blood pressure decreased from 173.7/124.8 mmHg to 143.2/97.8 mmHg. Both the group with isradipine monotherapy (n = 32) and the combination group (n = 11) showed a significant reduction in systolic and diastolic blood pressure. Diastolic blood pressure response, defined as a decline of more than 15 mmHg, was noted in 87.5% (monotherapy) and 72.7% (combination group) of patients. On the whole, blood pressure was normalized in 27.9% of the participants. Nineteen patients experienced 43 adverse events, most of which were rated mild to moderate. Therapy was withdrawn in only one patient (due to ankle edema). The most frequent adverse event was headache (20.9%).
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PMID:[Antihypertensive effect and adverse effects of isradipine in patients with sever hypertension. Results of an open multicenter study]. 876 50

The study covered influence of Isradipine (2.5 mg administered twice daily during 6 weeks) on blood circulation in the heart and occupationally important functions and traits among 30 drivers having mild and moderate arterial hypertension (AH). Systolic and diastolic pressure demonstrate reliable decrease in all the examinees with mild AH and in 93.8% of the examinees with moderate AH. Isradipine proved to influence positively decrease of hypertensive reactions and subclinical myocardial ischemia. Isradipine presented statistically significant improvement of the studied psychophysiologic parameters (quickness of latent and motor visual reaction, number of errors in color choice, exactness in following the mobile object). Thus, all above enables to recommend Isradipine (Lomir) as effective and safe method correcting arterial hypertension in drivers.
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PMID:[Isradipine in arterial hypertension in motor vehicle drivers]. 896 4

The development of atherosclerosis is clearly linked to the level of blood pressure. This is illustrated by the difference of atheroma formation in arteries as compared to veins, the development of atherosclerosis in veins transplanted to the arterial circulation or the finding of atherosclerosis also in the pulmonary circulation as an effect of pulmonary hypertension. Several experimental studies have also illuminated the strong link between high blood pressure and the development of atherosclerosis. From a therapeutic point of view it is worth noting that the lowering of blood pressure per se has a positive effect on the development of atherosclerosis. In particular, calcium antagonists have been shown, in numerous experimental studies, to have an antiatherosclerotic effect. The positive results in animal studies led to studies in man, the first of which was the MIDAS Study. The Multicentre Isradipine Diuretic Atherosclerosis (MIDAS) Study was a comparison between the dihydropyridine-derived calcium antagonist isradipine and hydrochlorothiazide in 883 hypertensive patients. B-mode ultrasonography of the carotid artery was used in order to evaluate changes in wall thickness and the development of atherosclerotic plaques during a 3-year period. The final publication has yet to appear in a medical journal. However, the study and its main findings have been presented at several international scientific meetings. In brief, isradipine was significantly more effective than hydrochlorothiazide in preventing an increase in intima-media thickness at several points of measurement in the carotid artery in spite of the fact that systolic blood pressure was not lowered as effectively by isradipine as by the diuretic therapy. There are numerous lessons to be learnt from MIDAS for future studies of this kind. A good example of this is the European Lacidipine Study of Atherosclerosis (ELSA) which is currently in progress in several European countries. By careful analysis of MIDAS an improved study design has been created, which should result in a definitive and irrefutable answer to the issue of the clinical importance of calcium antagonist treatment in the prevention of atherosclerosis.
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PMID:How to study the role of hypertension in atherosclerosis. Lessons from MIDAS. Multicentre Isradipine Diuretic Atherosclerosis Study. 897 77


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