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

Abnormal left ventricular diastolic performance, an early manifestation of hypertension in the heart, may precede the development of left ventricular hypertrophy. To assess effects of antihypertensive therapy on the heart, left ventricular mass (determined by echocardiography) and rapid left ventricular filling rate (determined by radionuclide ventriculography) were compared before and after 6 months of treatment of 16 patients. Nitrendipine (a dihydropyridine calcium channel blocker) was given alone or in combination with either propranolol or hydrochlorothiazide, or both, and significantly reduced blood pressure (156/103 +/- 12/7 to 137/89 +/- 10/6 mm Hg). In 6 of the 16 patients, left ventricular mass decreased by more than 10% (270 +/- 95 to 193 +/- 47 g, p less than 0.01); in the same patients, left ventricular filling rate increased (2.03 +/- 0.35 to 2.30 +/- 0.45 end-diastolic counts/s [EDC/s], p less than 0.01). In the one patient whose left ventricular mass increased (137 to 195 g), left ventricular filling rate decreased from 2.01 to 1.78 EDC/s. In the remaining nine patients who had no change in left ventricular mass, there was no significant changes in left ventricular filling. The changes in ventricular mass and filling could not be related to the extent of change in blood pressure or heart rate. These data suggest that regression of left ventricular mass during antihypertensive therapy with nitrendipine is accompanied by improved diastolic function.
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PMID:Improved left ventricular filling accompanies reduced left ventricular mass during therapy of essential hypertension. 378 47

Nitrendipine is a new nifedipine-like calcium antagonist antihypertensive agent. In this study, nitrendipine 5-40 mg orally bid was administered for up to three months to 16 patients with severe essential hypertension (untreated supine diastolic blood pressure greater than or equal to 115 mm Hg). Hydrochlorothiazide or propranolol or both were also given to patients who did not achieve goal blood pressure with nitrendipine alone. Five patients achieved goal blood pressure (supine less than or equal to 90 mm Hg) with nitrendipine alone and six more after the addition of a second drug, and only four required triple-drug therapy. One patient was terminated from the study because of headaches, a common nitrendipine side effect. This study demonstrates that nitrendipine is an effective and well-tolerated agent in the treatment of severe hypertension.
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PMID:Effectiveness of a new calcium antagonist in severe hypertension. 379 49

The authors have studied the effects of Nitrendipine, orally given in a dose of 20 mg, once a day for 30 days, in patients with mild to moderate hypertension. Twelve patients initially entered the study but four of them discontinued the treatment during the first week, because of unwanted side-effects: headaches, palpitation, sensations of burning skin. The remaining eight patients underwent a comparative evaluation at the end of a placebo period (DO) and at the end of the active treatment (D30), including successively: an automatic blood pressure recording with a Bard-Sentron device for 3 hours, then a determination of plasma renin activity, aldosterone and catecholamines, and finally a measurement of the blood pressure with a mercury manometer, at rest and during a standardized exercise on an ergometric bicycle. At D30, the Nitrendipine tablet was given one hour after the beginning of the automatic recording. The blood pressure measured with the mercury manometer (i.e. approximately 2 hours after the dose of Nitrendipine) significantly decreased from D0 to D30, at rest and during exercise, respectively from 161.5/104.6 to 132.8/82.5 mmHg and from 210.0/116.8 to 190.0/95.6 mmHg. The automatic recording provided, at D0, a mean blood pressure value of 152.4/90.6 mmHg; at D30, this mean value was as high as 142.6/90.7 mmHg during the hour preceding the dose of Nitrendipine (NS) and as high as 129.2/78.6 mmHg during the 2nd hour following the intake of the tablet (p less than 0.01). Plasma aldosterone and plasma renin activity significantly (p less than 0.05) increased from D0 to D30, whereas catecholamines did not change.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the antihypertensive effect and tolerability of a new delayed-action calcium channel blocker: nitrendipine, prescribed as a single daily dose of 20 mg]. 381 62

We examined the responses to the calcium channel blocker, nitrendipine, of isolated perfused kidneys from Dahl salt-sensitive (DS) and salt-resistant (DR) rats that had been stabilized on high- and low-NaCl diets. Blood pressures of high-salt DS rats exceeded those of the other three groups. After norepinephrine vasoconstriction sufficient to increase renal vascular resistance (RVR) by 50%, the superimposition of 10(-5) M nitrendipine increased the glomerular filtration rate (GFR) of high-salt DS rat kidneys by 125% over control values but returned the GFR of high-salt DR kidneys only to control. Nitrendipine superimposition increased the GFR of low-salt DS and DR rat kidneys by 124 and 40% over control values, respectively, and partially restored the RVR toward control. Nitrendipine alone, without norepinephrine, did not affect the GFR or RVR. The persistence within the DS kidney of an exaggerated glomerular circulatory "rebound" response to nitrendipine following the development of hypertension suggests the possibility of a maladaptation of DS kidney cell calcium regulation. The DR kidney manifests a similar response during salt restriction, but this disappears on a high-NaCl diet.
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PMID:Influence of salt on response to nitrendipine by Dahl rat kidney. 382 89

Nitrendipine, a calcium entry blocker, was administered by gavage (3 mg/100 g body weight/day) to rats with prolonged angiotensin-II-(AII) induced hypertension. AII was infused by osmotic minipump implanted subcutaneously. Persistent hypertension was established after 5 days. Normotensive control rats had empty sham pumps. Nitrendipine, administered from day 11 to 15 after pump implantation, normalized blood pressure consistently in AII rats, whereas it had no significant hypotensive effect in controls. Renal clearance experiments in anesthetized rats revealed that nitrendipine reversed all noted abnormalities of AII-infused rats, including hypertension and reductions in glomerular filtration rate, renal blood flow, and urinary sodium excretion. When receiving nitrendipine, sham controls did not show significant changes in blood pressure, renal function, or natriuresis. The results demonstrate that oral administration of nitrendipine is highly effective in normalizing blood pressure during prolonged AII-induced hypertension. The antihypertensive effect is achieved by this calcium entry blocker's vasodilatory action, supported by a marked natriuretic effect. By contrast, blood pressure and renal function of normotensive control rats were not appreciably affected by oral nitrendipine.
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PMID:Nitrendipine reverses vasoconstriction and renal hemodynamic changes in experimental hypertension. 608 60

The efficacy and safety of nitrendipine in oral doses of 5-40 mg twice daily, alone or in combination with hydrochlorothiazide (50-150 mg/day) and/or propranolol (40-120 mg/day), were evaluated in an open study of 50 patients with severe hypertension with supine diastolic blood pressure (BP) greater than 115 mm Hg. Forty-six patients with an initial mean supine BP of 190/120 +/- 21/8 reached 151/95 +/- 15/6 mm Hg at visit 9, and 40 patients with a baseline BP of 188/120 +/- 21/9 achieved mean BP of 142/87 +/- 15/7 mm Hg at the end of therapy (visit 16). Thirty (75%) of these patients were normotensive: 9 (22%) on nitrendipine alone, 3 (7.5%) on nitrendipine and hydrochlorothiazide, 7 (17.5%) on nitrendipine and propranolol, and 11 (27.5%) on triple therapy. In nine responders to nitrendipine alone, mean BP was reduced from 187/119 to 143/84 mm Hg. Mean standing BPs were similarly decreased. Initially, heart rate increased slightly but decreased to baseline at the end of therapy. Side-effects were generally mild to moderate and were attributable to vasodilatory effects of the drug. Three patients required drug discontinuation because of adverse effects. Addition of propranolol and hydrochlorothiazide was well tolerated. Nitrendipine (20-40 mg twice daily) alone or in combination with propranolol and hydrochlorothiazide offers an alternative therapeutic approach in the management of severe hypertension.
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PMID:Efficacy and safety of nitrendipine in patients with severe hypertension: a multiclinic study. 608 66

One-hundred and five patients with hypertension received nitrendipine (10-40 mg/day) or hydralazine (50-200 mg/day) in a double-blind randomized design. Nitrendipine decreased supine blood pressure 15/10 mm Hg, and hydralazine decreased it 11/11 mm Hg. Standing blood pressure was decreased 15/12 mm Hg by nitrendipine and 12/11 mm Hg by hydralazine. Supine and standing heart rate rose significantly after both drugs. Blood pressure variation through one dosing interval increased 42% when hydralazine was given but was not altered by nitrendipine. Side-effects from the two drugs were similar in patients who completed the study, but six patients discontinued participation due to side-effects of hydralazine, while only one discontinued due to nitrendipine side-effects. Ten patients required propranolol for hydralazine side-effects, and only three required it for nitrendipine side-effects. Nitrendipine and hydralazine are equally effective as antihypertensive monotherapy in patients with mild to moderate hypertension for periods up to 7 weeks, but nitrendipine appears to be better tolerated.
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PMID:Efficacy and safety comparison of nitrendipine and hydralazine as antihypertensive monotherapy. 608 77

The available evidence indicates that nitrendipine and other dihydropyridines with a similar pharmacological action exert their therapeutic effects by inhibiting Ca2+ channels. In our recent experiments, nitrendipine was shown to block K+-stimulated 45Ca2+ uptake and K+-induced contractions of isolated rabbit aortic rings. Its IC50 were 4.7 and 8.9 nM for inhibition of Ca2+ uptake and of contractions, respectively. There was no statistically significant difference between the two values. At higher concentrations, nitrendipine also reduced norepinephrine-induced 45Ca2+ uptake and norepinephrine-induced contractions of rabbit aortic strips. The norepinephrine-induced contractions were only slightly (21%) reduced by nitrendipine at 10 microM. Nitrendipine at 10 nM and higher concentrations inhibited K+- or angiotensin-II-(AII) induced release of aldosterone from isolated bovine adrenal glomerulosa cells. The drug was more potent and more effective in inhibiting K+- than AII-induced aldosterone release. Dantrolene, 25 microM, enhanced the inhibitory activity of nitrendipine on AII-stimulated aldosterone release. Acute renal failure produced by either glycerol or gentamicin in rats was antagonized by nitrendipine at oral doses of 15-25 mg/kg/day. Our studies confirmed previously reported observations that the usefulness of nitrendipine in the treatment of hypertension may be determined not only by its vasodilator action. We demonstrated that nitrendipine has a direct inhibitory effect on the release of aldosterone from adrenal glomerular cells. In addition to a previously described diuretic action, nitrendipine was shown to have renal cytoprotective activity.
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PMID:Some recent pharmacological findings with nitrendipine. 608 81

The antihypertensive effect of nitrendipine cannot be explained only by its reduction of the increased peripheral vascular resistance. In contrast to the antihypertensive vasodilators, nitrendipine improves impaired renal function and prevents generalized vasculopathy in hypertensive animals. Chronic treatment with nitrendipine prevents spontaneous (Okamoto rats) and salt-induced (Dahl rats) hypertension and cardiac hypertrophy. In rats with established hypertension, nitrendipine normalizes blood pressure, reduces cardiac hypertrophy, and improves renal ischaemia. In salt-induced malignant hypertension in stroke-prone spontaneously hypertensive rats, nitrendipine only slightly reduces blood pressure but dramatically improves survival and prevents vascular lesions in the heart, brain, and kidneys. Nitrendipine reduces the intracellular availability of calcium ions in vascular smooth muscle responsible for the increased peripheral and renovascular resistance in hypertension. Moreover, in preventing the deleterious calcium overload, nitrendipine preserves tissue integrity and increases life span in malignant hypertension.
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PMID:Mode of antihypertensive action of nitrendipine. 608 84

The antihypertensive effect of 20 mg of nitrendipine (BAY e 5009) was compared with that of 40 mg, administered orally once daily to 12 patients with essential hypertension (WHO I-II). The study was designed as a double-blind, within-patient comparison. The present results indicate that nitrendipine has a significant antihypertensive effect both at 20 and 40 mg as compared to placebo. There was no significant change in heart rate with 20 mg of nitrendipine, whereas there was a significant increase in heart rate after the first dose of 40 mg. Nitrendipine in dosages of 20 mg and 40 mg daily was equally effective as regards the antihypertensive effect. This applies both to the early response (first day) and the late response (3 weeks). Side effects were common in the 40-mg treatment group, but rare in the 20-mg group; only one patient had headache (three times) during the 3-week treatment period. It can be concluded that in mild hypertension, treatment with 20 mg of nitrendipine once daily constitutes an effective antihypertensive therapy. In more severe cases of hypertension, however, combination treatment with beta-blockers, for example, and/or repeated daily administration of nitrendipine ought to be investigated.
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PMID:Experience with nitrendipine--a new calcium antagonist--in hypertension. 618 74


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