Effect of the calcium antagonist nilvadipine on haemodynamics at rest and during cold stimulation in essential hypertension
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The immediate haemodynamic effects of the calcium antagonist nilvadipine have been studied in ten patients with established mild essential hypertension.
Nilvadipine 4 mg p.o. reduced both the systolic and diastolic blood pressures within 60 min, associated with a fall in total peripheral resistance and an increase in heart rate and cardiac index. The peak of blood pressure and total peripheral resistance reached during a cold pressor test were reduced by nilvadipine, but it did not affect the haemodynamic responsiveness to cold stimulation.
Plasma renin activity was unaltered and the plasma noradrenaline concentration was increased only slightly.
Thus, nilvadipine lowered blood pressure at rest and during cold stimulation as a result of arteriolar dilatation. The hypotensive effect at rest was associated with a reflex increase in heart rate and cardiac index.
Key wordsnilvadipine calcium antagonist essential hypertension antihypertensive drug stress cold pressor test haemodynamics plasma renin plasma noradrenaline
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- 1.Ohtsuka M, Ono T, Hiroi J, Esumi K, Kikuchi H, Kumada S (1983) Comparison of the cardiovascular effect of FR34235, a new dihydropyridine, with other calcium antagonists. J Cardiovasc Pharmacol 5: 1074–1082Google Scholar
- 2.Molyvdas PA, Sperelakis N (1986) Electropharmacological effects of a new dihydropyridine analog on isolated guinea pig papillary muscles and purkinje fibers. J Cardiovasc Pharmacol 8: 449–458Google Scholar
- 3.Furuta T, Shibata S, Kodama I, Yamada K (1983) Cardiovascular effects of FR34235, a new dihydropyridine slow channel blocker, in isolated rabbit myocardium and aorta. J Cardiovasc Pharmacol 5: 836–841Google Scholar
- 4.Ikeda M, Kaneko Y, Ishii M, Yasuda J, Yoshinaga K, Kajiwara N, Yamada K, Omae T, Masuyama Y, Kokubu T (1986) Efficacy of FK235 in essential hypertension. Multicenter open trial of monotherapy and combined therapy with diuretics. Jpn J Clin Exp Ther 63: 2017–2030Google Scholar
- 5.Takabatake T, Yamamoto Y, Ohta H, Nakamura S, Hara H, Ishida Y, Hashimoto N, Hattori N (1985) Blood pressure variability and haemodynamic response to stress in patients with paroxysmal elevation of blood pressure. Clin Exp Hypertens A7: 235–242Google Scholar
- 6.Tokuma Y, Fujiwara T, Noguchi H (1985) Determination of nilvadipine in human plasma by capillary column gas chromatography-negative-ion chemical-ionization mass spectrometry. J Chromatogr 345: 51–58Google Scholar
- 7.Mcleay RAB, Stallard TJ, Watson RDS, Littler WA (1983) The effect of nifedipine on arterial pressure and reflex control. Circulation 67: 1084–1090Google Scholar
- 8.Safar ME, Simon ACh, Levenson JA, Cazor JL (1983) Hemodynamic effects of diltiazem in hypertension. Circ Res 52: [Suppl I]: 169–173Google Scholar
- 9.Ventura HO, Messerli FH, Oigman W, Dunn FG, Reisin E, Fröhlich ED (1983) Immediate haemodynamic effects of a new calcium-channel blocking agent (nitrendipine) in essential hypertension. Am J Cardiol 51: 783–786Google Scholar
- 10.Braunwald E (1982) Mechanism of action of calcium-channel blocking agents. N Engl J Med 26: 1618–1627Google Scholar
- 11.Pedersen LO, Christensen NJ, Rämsch KD (1980) Comparison of acute effects of nifedipine in normotensive and hypertensive man. J Cardiovasc Pharmacol 2: 357–366Google Scholar
- 12.Burn JH, Gibbons WR (1965) The release of noradrenaline from sympathetic fibers in relation to calcium concentration. J Physiol 181: 214–223Google Scholar
- 13.Warltier DC, Zyvoloski MG, Gross GJ, Brooks HL (1984) Comparative actions of dihydropyridine slow channel calcium blocking agents in conscious dogs: alterations in baroreflex sensitivity. J Pharmacol Exp Ther 230: 376–382Google Scholar
- 14.Pedersen OL, Mikkelsen E, Christensen NJ, Kornerup HJ, Pedersen EB (1979) Effect of nifedipine on plasma renin, aldosterone, and catecholamines in arterial hypertension. Eur J Clin Pharmacol 15: 235–240Google Scholar
- 15.Takabatake T, Ohta H, Yamamoto Y, Maekawa M, Arai S, Hattori N, Nomura G (1982) Antihypertensive effect of nicardipine hydrochloride in essential hypertension. Int J Clin Pharmacol Ther Toxicol 20: 346–352Google Scholar
- 16.Park CS, Han DS, Fray JCS (1981) Calcium in the control of renin secretion: Ca2+ influx as an inhibitory signal. Am J Physiol 240: F70–74Google Scholar
- 17.Aoki K, Sato K, Kondo S, Yamamoto M (1983) Hypotensive effects of diltiazem to normals and essential hypertensives. Eur J Clin Pharmacol 25: 475–480Google Scholar