Effects of antihypertensive drugs on SBP variability are dose-dependent and persist when used in combinations .
Use of a high dose of a calcium channel blocker alone or in combination with other agents is therefore likely to be particularly effective in prevention of stroke
BACKGROUND AND PURPOSE Recent studies have shown that visit-to-visit blood pressure variability is a powerful risk factor for stroke , is reduced by calcium channel blockers and diuretics , and increased by β-blockers .
However , it is unknown whether these effects are dose-dependent and persist in combination with other drugs .
Monotherapy of stable angina with nicardipine hydrochloride: double-blind, placebo-controlled, randomized study.
The effect of nicardipine hydrochloride , a calcium-channel blocking agent , was studied in 46 patients with stable angina in a double-blind , placebo-controlled , r and omized , repeated cross-over protocol , using a 30 or 40 mg dose of nicardipine or placebo three times a day . Mean resting heart rate and blood pressure did not change significantly with 30 mg nicardipine ;  heart rate increased from 81 + /- 10 to 88 + /- 13 beats min-1 , systolic blood pressure decreased from 129 + /- 18 to 119 + /- 16 mmHg , and diastolic blood pressure from 81 + /- 12 to 74 + /- 11 mmHg ( P less than 0.01 for all three variables ) with a 40 mg dose . Using a treadmill exercise protocol , mean exercise duration increased from 5.4 + /- 1.8 to 6.0 + /- 1.8 min ( P less than 0.01 ) with 30 mg nicardipine , and from 5.8 + /- 1.7 to 6.6 + /- 1.9 min ( P less than 0.01 ) with 40 mg . Time to onset of angina increased from 4.6 + /- 1.9 to 5.2 + /- 1.7 min ( P less than 0.05 ) with 30 mg and from 5.1 + /- 1.8 to 5.7 + /- 1.8 min ( P = NS ) with 40 mg . Mean anginal frequency and sublingual nitroglycerin consumption were low during the cross-over placebo period and did not change significantly during therapy with nicardipine .  Non-cardiac side-effects were mild and required the withdrawal of only one patient from the study . However , during nicardipine therapy four patients had unstable angina and two developed a non-Q wave myocardial infa rct ion . Of these patients , five were receiving a beta-adrenergic blocker that was discontinued prior to the study . ( ABSTRACT TRUNCATED AT 250 WORDS
Effects of antihypertensive drugs on SBP variability are dose-dependent and persist when used in combinations .
Use of a high dose of a calcium channel blocker alone or in combination with other agents is therefore likely to be particularly effective in prevention of stroke
BACKGROUND AND PURPOSE Recent studies have shown that visit-to-visit blood pressure variability is a powerful risk factor for stroke , is reduced by calcium channel blockers and diuretics , and increased by β-blockers .
However , it is unknown whether these effects are dose-dependent and persist in combination with other drugs .