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Multicenter comparison of once‐ and twice‐daily isradipine to hydrochlorothiazide for the treatment of hypertension in elderly patients
Author(s) -
Holtzman Jordan L,
Abrams Alan,
Cutler Ralph,
Hamilton Bruce,
Kirkendall Walter M,
Neri Gilbert,
Stein Gerald H,
Matthews Katherine P
Publication year - 1990
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1990.196
Subject(s) - isradipine , hydrochlorothiazide , placebo , medicine , blood pressure , sitting , heart rate , diastole , pharmacology , dihydropyridine , anesthesia , calcium , alternative medicine , pathology
After 8 weeks of isradipine, a twice‐a‐day dihydropyridine calcium channel blocker, 49% of elderly patients showed a complete response (sitting diastolic blood presssure ≤85 mm Hg) and 36% showed a partial response (sitting diastolic blood pressure decrease ≥10 mm Hg) for an 85% total response rate. Hydrochlorothiazide gave a complete response in 36% of the patients and a partial response in 33%, for a 69% total response rate ( p < 0.0046). Because elderly subjects have reduced clearance for many drugs, we determined how those who responded to twice‐a‐day administration would respond to once‐a‐day administration. After 4 weeks of isradipine administered once a day, 54% of the patients showed a complete or partial response, whereas 38% of the patients who were changed to placebo showed a response. In contrast, 82% of patients receiving hydrochlorothiazide once a day showed a response, whereas 60% of patients who were changed to placebo showed a response. These data indicate that the standard formulation of isradipine was not effective when administered once a day. Clinical Pharmacology and Therapeutics (1990) 48, 590–597; doi: 10.1038/clpt.1990.196