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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-nine patients with mild to moderate essential hypertension participated in a parallel, single-blind study comparing 6 weeks' treatment of nicardipine hydrochloride (90 mg/day) with nifedipine (40 mg/day). Nicardipine-treated patients commenced therapy with a significantly higher mean supine diastolic blood pressure than the nifedipine-treated patients. There was a statistically significant fall in blood pressure (systolic and diastolic) on both treatments at the 3 and 6 week follow-up visits. On adjusting the results for the baseline inequality, no statistically significant differences were found between treatment groups. Seven patients withdrew from nifedipine therapy and six patients withdrew from nicardipine therapy due to adverse events. The results show that nicardipine hydrochloride at 90 mg/day is an effective anti-hypertensive agent. The incidence and nature of adverse events were similar on the two treatments.
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PMID:Comparison of the efficacy of nicardipine, a new calcium channel blocker, with nifedipine in the treatment of mild to moderate essential hypertension. 343 73

We studied the renal effects of nicardipine, a calcium entry blocker, in eight patients with essential hypertension (group A, WHO I or II), six hypertensive type II diabetics with mild-to-moderate nephropathy (group B, urinary albumin 200-789 mg/day), and six hypertensive type II diabetics with severe or advanced nephropathy (group C, urinary albumin 1,596-4,300 mg/day). The patients received an intravenous dose of nicardipine hydrochloride (0.5 mg) or saline placebo in a random order. Glomerular filtration rate (GFR) and renal blood flow (RBF) were measured by means of thiosulfate sodium and p-aminohippurate, respectively, during the 30 min after the nicardipine or saline injection. Blood pressures were serially monitored during the study. Nicardipine reduced both systolic and diastolic blood pressures significantly (P less than .05 to .01) at all measurement periods in all study groups compared with the respective placebo. Nicardipine increased RBF (P less than .01), GFR (P less than .05), and urinary Na+ excretion (P less than .01) and decreased total renal vascular resistance (P less than .01) in groups A and B, but these parameters remain unchanged in group C. The filtration fraction remained unaltered in all groups. The results indicate that nicardipine has several favorable renal effects with a concomitant hypotensive action in hypertensive type II diabetics with mild-to-moderate nephropathy, as observed in patients with uncomplicated essential hypertension, and the renal pharmacological responsiveness appears to be related to the severity of nephropathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal effects of nicardipine, a calcium entry blocker, in hypertensive type II diabetic patients with nephropathy. 353 Aug 49

In 10 patients with moderate to severe hypertension, the hemodynamic effects of ergometric exercise and nicardipine, a dihydropyridine calcium channel antagonist, were characterized under basal conditions and after 1 week of therapy. The responses of plasma renin activity and catecholamines were also assessed. Nicardipine induced significant reductions of systolic, diastolic and mean blood pressure under conditions of rest and peak exercise (p less than 0.001), mediated by reversal of vasoconstriction (p less than 0.001). Overall, cardiac index and stroke volume index responses were not significantly altered by nicardipine. Although rest pulmonary wedge pressure was unchanged (6 +/- 3 to 5 +/- 4 mm Hg), peak exercise pulmonary wedge pressure decreased from 24 +/- 22 to 7 +/- 5 mm Hg (p less than 0.001) with nicardipine therapy. This effect of nicardipine on pulmonary wedge pressure was present across all work loads studied, and was accompanied by reduction of peak exercise pulmonary artery pressure from 43 +/- 10 to 25 +/- 7 mm Hg (p less than 0.001). Oxygen consumption was unchanged, associated with reduction of arteriovenous oxygen difference (p less than 0.02). Both plasma renin activity (p less than 0.05) and norepinephrine (p less than 0.005) were significantly increased with nicardipine therapy. Thus, nicardipine produced significant blood pressure reduction by reversal of vasoconstriction in patients with essential hypertension. The preservation of cardiac output, with markedly reduced pulmonary wedge pressure, indicated that nicardipine improved ventricular performance in response to reversal of vasoconstriction.
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PMID:Systemic and pulmonary hemodynamic responses to nicardipine during graded ergometric exercise in patients with moderate to severe essential hypertension. 362 70

We studied the renal effects of nicardipine, a calcium entry blocker, in seven patients with mild-to-moderate essential hypertension. Glomerular filtration rate (GFR) and renal blood flow (RBF) were measured by means of thiosulfate and para-aminohippurate, respectively. Intravenous administration of nicardipine hydrochloride (0.5 mg) increased RBF by 26.8 +/- 5.8% (mean +/- SEM, p less than 0.01), GFR by 35.4 +/- 12.4% (p less than 0.05), and urinary excretion of sodium by 56.4 +/- 10.7% (p less than 0.05) with a significant (p less than 0.01) reduction in systolic and diastolic blood pressure as compared to control values. Nicardipine decreased total renal vascular resistance by 30.0 +/- 3.2% (p less than 0.05) from the control value, while filtration fraction remained unchanged. Our results indicate that nicardipine has several favorable renal effects with a concomitant hypotensive action in patients with mild-to-moderate essential hypertension.
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PMID:Renal effects of nicardipine in patients with mild-to-moderate essential hypertension. 395 66

The dose-response effects of a new slow-calcium-channel blocker, nicardipine, on the resting blood pressure and on the pressor responses induced by skin cold, isometric exertion, and dynamic exercise were examined in a single-blind placebo-controlled study in six male patients with stable uncomplicated essential hypertension. Nicardipine was administered orally in doses of 5 mg, 10 mg, 20 mg, and 20 mg each given three times daily consecutively for 1 week. At the end of each dose period the effects on blood pressure and heart rate at rest and during the three pressor stimuli were measured. There was a significant dose-related reduction in the resting diastolic blood pressure without change in pulse pressure, accompanied by an increase in heart rate. No postural effects on blood pressure were observed. There was a small reduction in the pressor response to hand cold, which was statistically significant at the higher doses. There was no attenuation of the increases in pressure and heart rate induced by handgrip contraction or submaximal treadmill walking at any dose of nicardipine. These results are compatible with direct relaxing effect of the drug on the smooth muscle of the arteriolar resistance vessels without substantial impairment of the sympathetic influences responsible for postural control of the systemic blood pressure or those involved in the pressor responses to the three stimuli tested.
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PMID:Influence of nicardipine on the blood pressure at rest and on the pressor responses to cold, isometric exertion, and dynamic exercise in hypertensive patients. 618 12

We have assessed the potential antihypertensive effect of a new slow channel blocker, nicardipine, in a group of patients with essential hypertension. Fourteen patients completed a study using the 'Oxford' system for recording blood pressure during free ambulation and physiological testing. An initial 24-h recording was performed on no treatment and repeated following chronic therapy with 40 mg b.d. of nicardipine. During each recording, the patients performed isometric and dynamic exercise according to a standardized protocol. Within-patient comparisons of consecutive mean hourly systolic and diastolic blood pressures showed a reduction throughout the 24 h during nicardipine therapy. The reduction in blood pressure was also maintained at the peaks of isometric and dynamic exercise. Side-effects were encountered frequently and led to four patient withdrawals. Nicardipine appears to be effective in reducing blood pressure although the frequency of encountered side-effects may limit its usefulness as a first-line antihypertensive agent.
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PMID:The effect of a new calcium channel blocker nicardipine on 24-hour ambulatory blood pressure and the pressor response to isometric and dynamic exercise. 668 Oct 29

Intra-arterial pressure, baroreflex sensitivity and the baroreflex set point were measured in eight patients with essential hypertension during a control period and then after acute treatment (2 h after a 30 mg oral dose) and after chronic treatment (at least 2 months) with nicardipine hydrochloride, a calcium channel antagonist. Mean intra-arterial blood pressure fell after the acute treatment from 130 +/- 14 (SD) control to 118 +/- 11 mmHg, P less than 0.05, and after chronic treatment to 112 +/- 19 mmHg, P less than 0.05. Heart rate increased from 72 +/- 11 control to 81 +/- 16 beats/min, P less than 0.05, during acute treatment indicating activation of the baroreflex control mechanism, but returned to control values with chronic treatment (72 +/- 11 control vs 69 +/- 9 beats/min chronic), indicating a significant shift to the left of the baroreflex set point. There was no change in baroreflex sensitivity after either acute or chronic treatment (control 4.7, acute 4.3, chronic 5.1 ms/mmHg, P not significant for all values). Nicardipine significantly reduces mean intra-arterial pressure both acutely and chronically; the latter is associated with a return of the heart rate to control values due to resetting of the baroreflex control mechanism.
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PMID:Baroreflex setting and sensitivity after acute and chronic nicardipine therapy. 669 56

Today calcium antagonists (Ca-antagonists) are widely used agents in the management of various diseases of the circulatory system. More than 20 years ago the Ca-antagonists of the so-called 1st generation (Verapamil, Diltiazem, Nifedipine) were introduced for treatment of angina pectoris and later of essential hypertension. In the last decade an increasing number of agents structurally related to dihydropyridines were developed for the treatment of hypertension and/or coronary heart disease or cerebral disorders; the main target was to reduce side effects and to guarantee once or at least twice daily administration. Therefore the Ca-antagonists of the so-called 2nd generation (e.g. Amlodipine, Felodipine, Isradipine, Nitrendipine, Nicardipine, Nimodipine, Nisoldipine) tend to longer elimination-half-lives; Amlodipin is an exception with an elimination-half-life of 30 hours on the average. Apart from elimination rates, however, the biopharmaceutical and pharmacokinetic characteristics of all Ca-antagonists are similar: they are highly cleared drugs and are relatively highly protein bound. As they are subject to significant hepatic first-pass-metabolism old age and hepatic disease will increase their plasma-concentrations. Renal impairment affects little their pharmacokinetics since the fraction eliminated unchanged by the kidneys is small. For most agents, plasma-concentration-response relationships have been described. With exception of nicardipine a linear pharmacokinetic in all Ca-antagonists was demonstrated. Drugs and food affecting hepatic blood flow and drug metabolising capacity have predictable interaction potential. With regard to the acute pharmacodynamic effects the Ca-antagonists show similar qualitative effects, though there are quantitative differences. Orally administered dihydropyridine-derivatives induce acute hypotensive effects, whereas the other compounds show clinically relevant hypotensive effects only when administered chronically per os or less pronounced when given as intravenous infusion.
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PMID:[Principles of the pharmacokinetics and pharmacodynamics of calcium antagonists]. 813 31

This study evaluated the effect of nicardipine, calcium channel blocker, monotherapy on blood pressure and metabolic changes. Various aspect of carbohydrate and lipoprotein metabolism were studied before and after 12 weeks of nicardipine treatment in 23 patients with mild to moderate essential hypertension. Nicardipine was well tolerated and induced a significant decrease (p < 0.001) in both systolic and diastolic blood pressure without any changes in heart rate. Plasma levels of fasting glucose, insulin, C-peptide and hemoglobin A1c, hepatic extraction of insulin were similar following nicardipine treatment. Plasma glucose and insulin responses to an oral glucose challenge did not change in association with nicardipine therapy. Although high density lipoprotein (HDL) cholesterol concentration increased slightly, it did not reach statistical significance. Total cholesterol and low density lipoprotein (LDL) cholesterol levels also increased insignificantly. LDL triglyceride and very low density lipoprotein (VLDL) triglyceride concentrations were higher marginally, which resulted in slightly but insignificantly increase in total triglyceride concentration in association with nicardipine monotherapy for 12 weeks. In conclusion, treatment of patients with mild to moderate hypertension with nicardipine led to lower blood pressure effectively while had no significant influence on carbohydrate and lipoprotein metabolism.
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PMID:Effect of nicardipine treatment on carbohydrate and lipoprotein metabolism in patients with hypertension. 849 May 96

This trial was designed to confirm the hypotensive action and safety of slow-release nicardipine, as a single drug or together with other hypotensive drugs, for the short-term treatment of mild-to-moderate hypertension, on a large case list of patients in 57 centers throughout Italy. A total of 1011 patients (502 M, 509 F) were admitted, mean age 58.6 +/- 9.1 years (range 25-87), mean weight 72.7 +/- 11.1 kg (range 43-128), with essential (972 cases) or secondary hypertension (39 cases). Nicardipine was given orally at a mean daily dosage of 80 mg (range 40-120), for four weeks. Clinically and statistically significant reductions in systolic and diastolic BP were observed at the end of treatment, with no noteworthy changes in heart rate. Nicardipine single-drug therapy restored normal blood pressure in 79.7% of patients with essential hypertension, and in 72.0% of those with secondary hypertension; nicardipine associated with other hypotensive agents achieved normal blood pressure in respectively 65.9% and 42.9%. Blood pressure returned to normal in 77.3% of patients with essential hypertension aged 65 years or under, and in 66.9% of those over 65 years old. These figures were respectively 70.8% and 46.7% for patients with secondary hypertension. The treatment was very well tolerated by 86.2% of patients; 140 (13.8%) presented adverse reactions, requiring dose reductions in 12, and discontinuation of treatment only in 24 cases. Five patients taking nicardipine together with another drug presented adverse reactions. These results confirm that slow-release nicardipine is effective and extremely well tolerated in the treatment of mild-to-moderate essential or secondary hypertension, in adults and the elderly.
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PMID:[Nationwide drug surveillance project on slow-release nicardipine in the short-term therapy of light/moderate arterial hypertension]. 855 69


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