Once-daily dihydropyridine calcium channel blockers appeared to lower blood pressure by a relatively constant amount throughout the 24-hour dosing interval .
Six dihydropyridine calcium channel blockers studied in this review lowered blood pressure by a relatively similar amount each hour over the course of 24 hours .
BACKGROUND Calcium channel blockers are a heterogeneous class of drugs , including dihydropyridine and non-dihydropyridine subgroups , commonly used in the treatment of hypertension .
A systematic review of the 24-hour time course of the blood pressure-lowering effect has not been published .
OBJECTIVES To assess how much variation there is in hourly systolic and diastolic blood pressure lowering by dihydropyridine calcium channel blockers over a 24-hour period in people with hypertension aged 18 years or over , with baseline systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg , or both .
Sustained-release nicardipine in mild-to-moderate hypertension.
STUDY OBJECTIVE To evaluate the antihypertensive effects and tolerability of a sustained release preparation of nicardipine ( NIC SR ) , a dihydropyridine calcium channel antagonist . DESIGN AND INTERVENTIONS After at least 1 week without receiving antihypertensive medications and 2 weeks of single-blind placebo treatment , the patients were r and omized to receive in a double-blind fashion , either placebo or NIC SR 30 , 45 , or 60 mg twice daily at 12-h intervals for 12 weeks . Supine and st and ing blood pressure were measured in all patients and 24-h ambulatory blood pressure monitoring was performed in a subset of 75 patients at baseline during treatment with single-blind placebo and during the double-blind treatment period . SETTING Academic and private hypertension research clinics . PATIENTS Two hundred sixty-four patients with supine diastolic blood pressures of 95 to 114 mm Hg , ranging in age from 22 to 75 years and in weight from 50 to 137 kg , approximately evenly divided by gender ; one third were black . RESULTS In comparison with placebo , all doses of NIC SR significantly reduced systolic and diastolic blood pressures , with a trend toward greater effects from 45 to 60 mg twice daily than with 30 mg twice daily . At all doses , reduction of blood pressure from baseline levels was fully apparent within the first 2 weeks of therapy and was maintained throughout the remaining 10 weeks of the trial . Ambulatory blood pressure monitoring demonstrated that the antihypertensive effect was maintained throughout the dosing interval . Adverse effects were primarily extensions of pharmacologic activity ( eg , pedal edema , flushing ) . Six percent of the placebo group and 10 percent of the combined NIC SR groups experienced at least one adverse event that was judged to be probably related to therapy . Withdrawals due to unacceptably high blood pressure totaled 5 percent of the combined NIC SR groups and 25 percent of the placebo group . CONCLUSIONS Sustained-release nicardipine at a dose of 30 to 60 mg every 12 h provided effective and generally well-tolerated antihypertensive control throughout the day in most patients with mild-to-moderate essential hypertension
Once-daily dihydropyridine calcium channel blockers appeared to lower blood pressure by a relatively constant amount throughout the 24-hour dosing interval .
Six dihydropyridine calcium channel blockers studied in this review lowered blood pressure by a relatively similar amount each hour over the course of 24 hours .
BACKGROUND Calcium channel blockers are a heterogeneous class of drugs , including dihydropyridine and non-dihydropyridine subgroups , commonly used in the treatment of hypertension .
A systematic review of the 24-hour time course of the blood pressure-lowering effect has not been published .
OBJECTIVES To assess how much variation there is in hourly systolic and diastolic blood pressure lowering by dihydropyridine calcium channel blockers over a 24-hour period in people with hypertension aged 18 years or over , with baseline systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg , or both .