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Nicardipine and verapamil in essential hypertension
Author(s) -
ALKHAWAJA I. M.,
CARUANA M. P.,
LAHIRI A.,
WHITTINGTON J. R.,
LEWIS J. G.,
RAFTERY E. B.
Publication year - 1986
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1986.tb00332.x
Subject(s) - nicardipine , verapamil , medicine , blood pressure , heart rate , crossover study , ejection fraction , cardiology , placebo , essential hypertension , anesthesia , heart failure , calcium , alternative medicine , pathology
1 Nicardipine 30 mg three times daily and verapamil 160 mg twice daily have been compared in 30 patients with essential hypertension using a two‐period crossover clinical trial with 6 week treatment periods. 2 Blood pressure, heart rate and radionuclide left ventricular function were measured before and after exercise on both treatments. In addition to ejection fraction and ejection time, the left ventricular pressure volume ratio (P/V ratio) and left ventricular circumferential fibre shortening (VcF) were determined from the radionuclide scans. 3 Two patients were withdrawn from the trial during each of the treatment periods because of possible side‐effects of therapy. Three patients were not analysed because of early crossover due to side‐effects, leaving 23 completed studies. 4 Both treatments resulted in similar reductions in blood pressure, which were statistically significant with respect to the placebo‐treated baseline. There was a significant difference between the effect of the two treatments on heart rate; both at rest and peak exercise, verapamil produced significant falls in heart rate but nicardipine produced little change. Neither treatment altered exercise capacity. 5 Both treatments produced similar increases in resting ejection fraction. Nicardipine resulted in a small decrease in ejection time and verapamil in a small increase ( P < 0.001 between treatments). 6 Neither treatment produced significant change in resting P/V ratio. However, VcF improved significantly with nicardipine but was virtually unchanged with verapamil. 7 Nicardipine has a similar hypotensive efficacy to that of verapamil, but may be safer in the treatment of patients with depressed or compromised cardiac function.