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Titolo:
Comparison of two calcium blockers on hemodynamics, left ventricular mass,and coronary vasodilatory in advanced hypertension
Autore:
Diamond, JA; Krakoff, LR; Goldman, A; Coplan, N; Gharavi, A; Martin, K; Goldsmith, R; Henzlova, MJ; Machac, J; Phillips, RA;
Indirizzi:
Mt Sinai Med Ctr, Zena & Michael A Wiener Cardiovasc Inst, Sect Hypertens,New York, NY 10029 USA Mt Sinai Med Ctr New York NY USA 10029 t Hypertens,New York, NY 10029 USA Mt Sinai Med Ctr, Zena & Michael A Wiener Cardiovasc Inst, Sect Nucl Cardiol, New York, NY 10029 USA Mt Sinai Med Ctr New York NY USA 10029 cl Cardiol, New York, NY 10029 USA Lenox Hill Hosp, Div Cardiol, New York, NY 10021 USA Lenox Hill Hosp New York NY USA 10021 Div Cardiol, New York, NY 10021 USA
Titolo Testata:
AMERICAN JOURNAL OF HYPERTENSION
fascicolo: 3, volume: 14, anno: 2001,
pagine: 231 - 240
SICI:
0895-7061(200103)14:3<231:COTCBO>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-RATE; FLOW RESERVE; DIASTOLIC FUNCTION; BLOOD-PRESSURE; DOUBLE-BLIND; HYPERTROPHY; MORTALITY; DISEASE; ANTAGONISTS; MEN;
Keywords:
hypertension; calcium channel antagonists; hypertrophy; coronary microcirculation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Diamond, JA Mt Sinai Med Ctr, Cardiovasc Inst, Box 1030,1 Gustave L Levy Pl, New York,NY 10029 USA Mt Sinai Med Ctr Box 1030,1 Gustave L Levy Pl New York NY USA 10029
Citazione:
J.A. Diamond et al., "Comparison of two calcium blockers on hemodynamics, left ventricular mass,and coronary vasodilatory in advanced hypertension", AM J HYPERT, 14(3), 2001, pp. 231-240

Abstract

Dihydropyridine acid nondihydropyridine calcium channel blockers (CCB) differ in pharmacologic characteristics. Few clinical studies distinguish effects of CCB as monotherapy. We conducted a comprehensive comparison of two CCB on patients with moderate to severe hypertension. Thirty patients with pretreatment diastolic blood pressures greater than or equal to 100 mm HE were randomly assigned to either nifedipine-GITS or verapamil-SR. Dose titration achieved a diastolic blood pressure of less than or equal to 95 mm Hg or a decrease of greater than or equal to 15 mm Hg over 4 weeks. Clinic blood pressure (BP), 24-h ambulatory BP, exercise BP, left ventricular mass, systolic and diastolic function by echocardiography, and coronary flow reserve by split-dose thallium-201 imaging with adenosine were assessed at baseline, end of titration, 3 months and 6 months of treatment. Plasma renin activity, atrial natriuretic peptide, norepinephrine, and epinephrine were assayed. Both drugs caused similar reductions in clinic and 24-h ambulatory BP and similar reductions in left ventricular mass index. Compared to nifedipine-GITS, verapamil-SR produced a significantly lower resting and peak exercise heart rate. Nifedipine-GITS elicited a lower peak exercise systolic BP. At end titration nifedipine-GITS produced lower plasma atrial natriuretic peptide levels, no longer apparent by 6 months. Plasma norepinephrine was lower with verapamil-SR, also at end titration and at 3 months, but not at 6months. Plasma epinephrine and plasma renin activity were unchanged by either drug. There was no difference for systolic or diastolic left ventricular function or coronary flow reserve between the two treatments. Once daily nifedipine-GITS and verapamil-SR are equally effective for reduction of arterial pressure in moderate to severe hypertension. Differences in their hemodynamic profiles and neurohormonal responses are consistent with preclinical pharmacologic characteristics. The clinical implications of their similarities and differences remain to be fully evaluated in outcome studies. (C)2001 American Journal of Hypertension, Ltd.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 18:02:16