Summary
Calcium antagonists, particularly those derived from the dihydropyridine class, have shown remarkable efficacy in the treatment of hypertension and other cardiovascular disorders. This review will concentrate on the use of one of the newer compounds in this category, isradipine, in the treatment of arterial hypertension. Isradipine is a calcium antagonist with marked vascular selectivity and, in practical terms, is devoid of cardiac effects. Its usefulness in hypertension is well documented, both when used as single drug treatment and in combination with other agents, particularly β-blockers.
Isradipine is well tolerated, does not cause metabolic disturbances and, apart from the typical dihydropyridine-type vascular adverse effects, e.g. flushing and ankle oedema, it does not cause any specific side effect.
Some results obtained with isradipine in animal studies, e.g. the antiatherosclerotic effect and the brain tissue preserving effect seen in experimental stroke, appear to hold great promise for future important clinical applications for isradipine.
Similar content being viewed by others
References
Andersson K-E. Effects of calcium and calcium antagonists on the excitation-contraction coupling in striated and smooth muscle. Acta Pharmacologica et Toxicologica 43(Suppl. 1): 5–14, 1978
Aoki K, Kondo S, Mochizuki A, Yoshida T, et al. Antihypertensive effect of cardiovascular Ca2+-antagonist in hypertensive patients in the absence and presence of beta-adrenergic blockade. American Heart Journal 96: 218–226, 1978
Bender F. Die Behandlung der tachykarden Arrhythmien und der arteriellen Hypertonie mit Verapamil. Arzneimittel Forschung 20: 1310–1316, 1970
Blaustein MP. Sodium ions, calcium ions, blood pressure regulation, and hypertension: a reassessment and a hypothesis. American Journal of Physiology 232: 165–173, 1977
Brittinger WD, Schwarzbeck A, Wittenmeier KW, Twittenhof WD, et al. Klinisch-experimentelle Untersuchungen über die blutdrucksenkende Wirkung von Verapamil. Deutsche Medizinische Wochenschrift 95: 1871–1877, 1970
Burger KJ, Weidinger G, Welzel D. Efficacy and tolerability of the new calcium antagonist isradipine in essential hypertension. Journal of Cardiovascular Pharmacology, in press a
Burger KJ, Weidinger G, Welzel D. Superior tolerability of isradipine compared to nifedipine in mild essential hypertension. Journal of Cardiovascular Pharmacology, in press b
Dahlöf B, Andrén L, Eggertsen R, Jern S, Svensson A, et al. Long-term experience with the combination of pindolol and isradipine in essential hypertension. American Journal of Medicine 84(Suppl. 3B): 4–7, 1988
Ebashi S. Regulation of muscle contraction. Proceedings of the Royal Society London, 207, 259, 1980
Eggertsen R, Svensson A, Dahlöf B, et al. Additive effect of isradipine in combination with captopril in hypertensive patients. American Journal of Medicine 86(Suppl. 4A): 124–126, 1989
Godfraind T. Classification of calcium antagonists. American Journal of Cardiology 59(Suppl. B): 11–23, 1987
Hansson L, Dahlöf B. Antihypertensive effect of a new dihydropyridine calcium antagonist, PN 200-110 (isradipine) combined with pindolol. American Journal of Cardiology 59(Suppl. B): 137–140, 1987
Hof RP. Comparison of cardiodepressant and vasodilator effects of PN 200-110 (isradipine), nifedipine and diltiazem in anesthetized rabbits. American Journal of Cardiology 59(Suppl. B): 37–41, 1987
Hof RP, Salzmann R, Siegl H. Selective effects of PN 200-110 (isradipine) on the peripheral circulation and the heart. American Journal of Cardiology 59(Suppl. B): 30–36, 1987
Hof RP, Scholtysik G, Loutzenhizer R, Vourela HJ, Neumann P. PN 200-110, a new calcium antagonist: electrophysiological, inotropic and chronotropic effects on guinea-pig myocardial tissue and effects on contraction and calcium uptake of rabbit aorta. Journal of Cardiovascular Pharmacology 6: 399–406, 1984
Isradipine in Hypertension Study Group. A multicenter evaluation of the safety and efficacy of isradipine and atenolol in the treatment of hypertension. American Journal of Medicine 86(Suppl. 4A): 119–123, 1989
Kirkendall WM. Comparative assessment of first-line agents for treatment of hypertension. American Journal of Medicine 84(Suppl. 4A): 94–97, 1988
Krusell LR, Jespersen LT, Schmitz A, Thomsen K, Pedersen OL. Repetitive natriuresis and lowering of blood pressure — long-term calcium entry blockade with isradipine. Hypertension 10: 577–581, 1987
Lederballe Pedersen O. Calcium blockade as therapeutic principle in arterial hypertension. Acta Pharmacologica et Toxicologica 49(Suppl. II): 1–31, 1981
Opie LH, Bühler FR, Fleckenstein A, Hansson L, Harrison DC, et al. International Society and Federation of Cardiology Working Group on classification of calcium antagonists for cardiovascular diseases. American Journal of Cardiology 60: 630–632, 1987
Persson B, Andersson OK, Wysocki M, et al. Renal and hemodynamic effects of isradipine in essential hypertension. American Journal of Medicine 86(Suppl. 4A): 60–64, 1989
Sauter A, Rudin M. Treatment of hypertension with isradipine reduces infarct size following stroke in laboratory animals. American Journal of Medicine 86(Suppl. 4A): 130–133, 1989
Stull JT, Sanford CF. Differences in skeletal, cardiac and smooth muscle contractile element regulation by calcium. In Weiss (Ed.) New perspectives on calcium antagonists, pp. 35–43, American Physiological Society, Bethesda, 1981
Vanhoutte PM. The expert committee of the World Health Organization on Classification of Calcium Antagonists. The viewpoint of the rapporteur. American Journal of Cardiology 59(Suppl. A): 3–8, 1987
Van Zwieten PA. Calcium entry blockers (calcium antagonists). In van Zwieten (Ed.) Handbook of Hypertension, Vol. 3, pp. 331–342, Pharmacology of antihypertensive drugs, Elsevier, Amsterdam, 1984
Vermeulen A, Wester A, Willemse PFA, Lustermans FA, Stegeman CJ, et al. Comparison of isradipine and diltiazem in the treatment of hypertension. American Journal of Medicine 84(Suppl. 3B): 42–45, 1988
Weinstein DB, Heider JG. Antiatherogenic properties of calcium antagonists. American Journal of Cardiology 59(Suppl. B): 163–172, 1987
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hansson, L. Isradipine in Hypertension. Drugs 40 (Suppl 2), 10–14 (1990). https://doi.org/10.2165/00003495-199000402-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00003495-199000402-00005