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

This study investigate the effects of Nicardipine treatment on regression of left ventricular hypertrophy (LVH), coronary hemodynamic and myocardial mechanical performance. 30 Sprague-Dawley male rats were divided into 3 groups: sham operated rats control group (SHC), untreated hypertensive rats group (RHR-U), treated hypertensive rats group (RHR-N). Systemic and coronary hemodynamics were determined by using left atrial injection of radioactive microspheres, 16 weeks after clipping. Mechanical performance was measured on isolated papillary muscle from the same animal. Results (mean +/- SEM) (Table: see text). Nicardipine treatment (10 to 15 mg intraperitoneal dosage during 8 weeks), led to: an efficient but incomplete control of hypertension. a reduction of left ventricular mass in proportion lesser than pressure decrease. a raise of coronary blood flow at rest with inversion of flow distribution between endocardium an epicardium. a decrease of "maximal" coronary blood flow. a reversal of impaired myocardial mechanical parameters towards control values except for contraction timing parameters. Decrease of "maximal" coronary blood flow could have deleterious effects on cardiac function.
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PMID:[Effects of nicardipine on left ventricular hypertrophy of the rat with renovascular arterial hypertension]. 297 1

The relationship between age and the antihypertensive efficacy of calcium antagonists has been investigated by different authors with conflicting results. In order to evaluate this relationship an Italian multicentre study investigated 2184 patients with mild to moderate hypertension with an age range of 24-90 years. Initial treatment consisted of nicardipine monotherapy (daily dose 40-80 mg/day in two or three oral administrations); after 4 weeks other antihypertensive agents could be added in non-responders (seated blood pressure greater than 160/95 mmHg). The patients were divided into four groups according to age (less than or equal to 55 years, 56-65 years, 66-75 years and greater than 75 years). Nicardipine-based treatment reduced systolic and diastolic blood pressures to similar levels independently of the age of the patients. The correlation between systolic blood pressure reduction and age was only 0.141 (NS). The percentage of patients treated with nicardipine monotherapy was similar in all age groups, but the incidence of side effects, mostly transient and mild, was lower in older than in younger patients. In patients older than 65 years with isolated systolic hypertension (systolic pressure greater than 160 and diastolic pressure less than 90 mmHg), nicardipine-based therapy significantly lowered systolic blood pressure only from 180 +/- 11/87 +/- 6 to 148 +/- 14/84 +/- 8 mmHg.
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PMID:Antihypertensive efficacy of nicardipine-based treatment in patients of different age and in patients with isolated systolic hypertension. 307 95

Nicardipine hydrochloride is the first intravenous dihydropyridine calcium antagonist to become available in the United States. Its chemical structure makes it unique among its drug class and confers clinically useful properties for the treatment of acute cardiovascular conditions, such as ischemia, hypertension, congestive heart failure, cerebrovascular disease, and related disorders. For patients with coronary artery disease, IV nicardipine reduces myocardial oxygen demand by reducing afterload and increases myocardial oxygen supply through coronary vasodilatation. Preliminary data suggest that nicardipine also has cardioprotective and vascular antispastic effects. Nicardipine has been shown to be effective in the treatment of mild to moderate hypertension both as monotherapy and in combination with other antihypertensive agents. In congestive heart failure, nicardipine enhances left ventricular pumping activity and augments coronary blood flow beyond that required by increased myocardial oxygen consumption. Its lack of major effects on sinoatrial and atrioventricular conduction makes it safe for use in patients with certain types of conduction disturbances. Nicardipine's rapid onset and short duration of action are additional advantages for use in the management of acute cardiovascular disorders.
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PMID:Intravenous nicardipine: cardiovascular effects and clinical relevance. 307 10

The effects of nicardipine hydrochloride, a calcium channel blocker, upon cerebrospinal fluid pressure (CSFP) were investigated in 47 patients without intracranial pathology who were assigned to one of three groups: group 1 (n = 17), who received 0.01 mg/kg nicardipine, group 2 (n = 17), who received 0.02 mg/kg, and group 3 (n = 13), who received 0.03 mg/kg. A spinal needle was inserted into the subarachnoid space to permit continuous measurement of CSFP. Nicardipine produced statistically significant increases in CSFP: from a mean of 7.6 to 11.6 mm Hg in group 1, 7.2 to 12.2 mm Hg in group 2, and 7.4 to 13.8 mm Hg in group 3 (P less than 0.001 in each group). CSFP after nicardipine attained its maximum in 1-2 min, the gradually returned to control levels. Changes in CSFP were always associated with statistically significant decreases in arterial blood pressure and cerebral perfusion pressure, whereas the heart rate showed significant increases. Nicardipine may increase CSFP to undesirable levels in patients with intracranial hypertension.
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PMID:The effects of nicardipine on cerebrospinal fluid pressure in humans. 308 18

In arterial hypertension, hyperviscosity with hemorheological disturbances and platelet dysfunction may play a role in the prognosis and complications of the disease. We studied the effects of Nicardipine (NIC) on these blood disturbances in a group of 21 untreated patients with essential hypertension, aged 25 to 70 years (SBP/DBP = 185 +/- 28/105 +/- 17 mmHg). During one hour before and 4 hours after the IV injection of single doses of 5, 7.5 or 10 mg NIC over 5 min, blood pressure was recorded automatically (Dinamap). Hemorheological variables and platelet function were studied before and 30 min, 3 h and 24 hours after the injection. NIC lowered blood pressure and increased heart rate significantly (At 5 min, SBP = -24 mmHg; DBP = -18 mmHg; HR = +22 b/min). These effects were dose-dependent with rapid onset and short duration (less than 2 hrs). NIC decreased plasma viscosity from 1.36 +/- 0.08 to 1.30 +/- 0.07 Cst; p less than 0.01, whole blood viscosity from 22.4 +/- 2.8 to 20.7 +/- 1.5 mPas; p less than 0.05 for gamma = 0.512 s-1, and erythrocyte filterability with the Ca++ ionophore A 23187 from 16.3 +/- 3.8 to 13.5 +/- 3.1; p less than 0.01. Platelet aggregation with ADP was unchanged, but aggregation with A 23187 decreased from 46.9 +/- 21.2 to 31.3 +/- 25.6; p less than 0.05, as well as plasma levels of beta-thromboglobulin (71.2 +/- 29.8 to 55.4 +/- 24.3 ng/ml; p less than 0.02) and platelet generated malonaldehyde (7.2 +/- 1.8 to 6.7 +/- 1.4 nM/10(9) platelets; NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of intravenous nicardipine on blood pressure, hemorheology platelet function in arterial hypertension. Dose-effect relations]. 311 84

The two dihydropyridine calcium antagonists, nicardipine and nifedipine, were compared in 12 patients with both stable angina pectoris and systemic hypertension using a double-blind, crossover protocol. After a 2-week placebo run-in period, each patient was randomized to either nicardipine or nifedipine; each drug was titrated up to either blood pressure normalization, appearance of adverse effects, or maximal dosage (40 mg, three times a day with nicardipine and 30 mg, three times a day with nifedipine) and then administered for 4 weeks. Maximal symptom-limited exercise tests were performed at the end of the placebo run-in and each treatment period, 3 and 8 hours after drug administration. Nicardipine and nifedipine were used at the mean doses of 100 +/- 20 mg/day and 57 +/- 20 mg/day, respectively. Both drugs reduced, significantly and similarly, standing and supine blood pressure, frequency of anginal episodes, and nitroglycerin consumption. At 3 hours after drug administration, exercise duration and time to 1-mm ST depression increased significantly from 402 +/- 84 and 306 +/- 108 seconds, respectively, with placebo; to 533 +/- 135 and 442 +/- 138 seconds during nicardipine; and to 518 +/- 118 and 437 +/- 133 seconds during nifedipine, with a concomitant reduction of peak ST depression. Both submaximal and maximal exercise diastolic blood pressure were significantly reduced by the two calcium antagonists whereas systolic blood pressure was decreased only at submaximal but not at maximal exercise; the heart rate was not significantly modified by the two drugs at any exercise stage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A randomized double-blind crossover study of nicardipine and nifedipine in patients with angina pectoris and concomitant essential hypertension. 315 18

Nicardipine is an antagonist of calcium influx through the slow channel of the cell membrane and has been shown to be an effective and relatively well-tolerated treatment for stable effort angina and rest angina due to coronary artery spasm, and mild to moderate hypertension. Although its exact mechanism of action in these disease states has not been precisely defined, the potent coronary and peripheral arterial dilator properties of nicardipine, with concomitant improvements in oxygen supply/demand and reductions in systemic vascular resistance, are of major importance. Clinical studies have shown that nicardipine appears to be effective in the treatment of chronic stable exercise-induced angina pectoris and possibly in angina at rest due to coronary artery spasm. In the treatment of stable angina, nicardipine has proved to be equally as effective as nifedipine. However, haemodynamic and clinical studies indicate that nicardipine may have a further advantage of not depressing cardiac conduction or left ventricular function, even in patients with compromised cardiac pumping ability. Nicardipine also appears to be useful as initial monotherapy or in combination with other antihypertensive drugs when used in the treatment of mild to moderate hypertension, and may have some advantages over other vasodilators in this regard in that it may not be as frequently associated with fluid retention or weight gain as other similar drugs. In the treatment of hypertension nicardipine has been shown to be as effective as drugs such as hydrochlorothiazide, cyclopenthiazide, propranolol and verapamil in short term studies although confirmation of its long term usefulness in well-designed clinical trials is still required. Similarly, although the use of nicardipine in other disorders such as congestive heart failure and cerebrovascular disease has provided encouraging preliminary results, more studies are needed to clarify its place in their treatment. Side effects appear to be dose related and more frequent within the first few weeks of therapy. Most of these effects are minor and transient in nature and include headache, flushing and peripheral oedema. Thus, there is no doubt that nicardipine provides a suitable alternative to other drugs available for the treatment of angina and hypertension. However, further well-designed comparative clinical trials are needed to clarify its relative place in the long term management of these disorders.
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PMID:Nicardipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy, in the treatment of angina pectoris, hypertension and related cardiovascular disorders. 329 16

Nicardipine is currently being evaluated in clinical trials as a treatment for angina and hypertension. Over 2,000 patients have received nicardipine, most at dosages of 20 to 40 mg 3 times daily. In 12 double-blind, parallel-group studies (4 of them placebo-controlled) the efficacy of nicardipine was evaluated in mild to moderate hypertension; supine systolic blood pressure was lowered by 10 to 15 mm Hg and supine diastolic blood pressure by 10 mm Hg. A clear dose response is present at dosages from 10 to 40 mg 3 times daily. Patients with angina were treated in 9 double-blind, crossover design studies: 4 of these were placebo-controlled; 3 were comparison studies with beta blockers; 2 were comparisons with nifedipine. Treadmill exercise tests were the major measure of efficacy. Results of these studies showed consistent, statistically significant improvement in exercise tolerance and time to onset of angina, and clinical improvement in patients with chronic stable angina. The effective dosages of nicardipine were 30 or 40 mg 3 times daily. A placebo-controlled study demonstrated remarkable efficacy in patients with vasospastic angina. No deaths or serious adverse reactions were attributed to nicardipine during clinical trials. The most common side effects reported were flushing, palpitations, headache and pedal edema. These appeared to be due to the drug's pharmacologic property of vasodilatation.
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PMID:An overview of the safety and efficacy of nicardipine in clinical trials. 330 Feb 39

Nicardipine has been shown to lower blood pressure in patients with uncomplicated hypertension as well as in patients with concomitant renal impairment, coronary artery disease or congestive heart failure. The decrease in blood pressure induced by nicardipine is related to a concurrent decrease in total peripheral vascular resistance. The antihypertensive actions of nicardipine are maintained during long-term administration without the development of tachyphylaxis. In patients receiving diuretics or beta blockers, the addition of nicardipine has been shown to produce an additional decrease in blood pressure. The combined use of nicardipine and beta blockers may be beneficial in the treatment of hypertension: the increase in peripheral vascular resistance during beta blockade may be prevented by nicardipine-induced vasodilation; conversely, beta blockers may prevent reflex tachycardia and other consequences of peripheral vasodilatation. Although nicardipine may increase the heart rate acutely, tachycardia does not occur during long-term therapy. Preliminary data suggest that nicardipine exerts potent antihypertensive effects in patients with renal insufficiency without altering renal parameters. In patients with normal renal function, nicardipine has been shown to cause acute natriuresis and an increase in renal blood flow and glomerular filtration rate. Nicardipine also has a favorable effect on peripheral and cerebral blood flow. Like other dihydropyridines, nicardipine appears to have an antiatherogenetic effect in the experimental model. Short-term therapy with nicardipine does not affect serum lipid levels. Results from several studies suggest that nicardipine is an effective antihypertensive agent that can be used as monotherapy or in combination with other drugs such as beta blockers or diuretics.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nicardipine for systemic hypertension: effects on blood pressure and target organ function. 330 Feb 38

We report seven cases out of eight reversible raises (350% of mean increase) of cyclosporine (CsA) plasma levels in patients receiving the new calcium channel blocker nicardipine (Loxen-Sandoz) and CsA after renal transplantation. Nicardipine was introduced 3 to 36 weeks post transplantation in 7 cases of hypertension and 1 case of angina pectoris. CsA plasma levels raised considerably 1 to 30 days after nicardipine introduction and returned to pretreatment levels 1 to 7 days after withdrawal. Serum creatinine increased in 1/8 patients. These data suggest that nicardipine interferes with CsA metabolism and this interaction is reversible after nicardipine discontinuation. These findings point out the fact that at least some calcium channel blockers need to be cautiously used in patients receiving CsA.
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PMID:Confirmation of the interaction between cyclosporine and the calcium channel blocker nicardipine in renal transplant patients. 331 9


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