Safety, efficacy and pharmacokinetics of nicardipine in elderly hypertensive patients

1 Eighty‐eight elderly patients (aged 63–84 years) with essential hypertension were randomised to receive either nicardipine (57 patients) or placebo (31 patients) for 6–8 weeks in this double‐blind, parallel group study. 2 The dosage of nicardipine was titrated according to blood pressure response. Doses ranged from 10 mg to 30 mg three times daily; the majority of patients received the 20 mg regimen. 3 At the last study visit, the mean reduction in systolic/diastolic blood pressure in the nicardipine group was 16.6/11.1 mmHg as compared to 5.1/4.7 mmHg for the placebo group. The difference between the two groups was statistically significant for both systolic and diastolic pressures ( P < 0.001). 4 Orthostatic blood pressure changes did not occur any more frequently in the nicardipine‐treated group. Pulse rate and body weight changes on nicardipine were negligible. 5 Nicardipine plasma concentrations showed no accumulation over time in the elderly patients, and were similar to those reported previously in younger volunteers. 6 Adverse effects were reported in 53% of patients on nicardipine and 45% on placebo. Those side effects occurring more often on nicardipine were primarily related to its vasodilatory properties. 7 Nicardipine is an effective, well tolerated antihypertensive agent in geriatric patients.