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 .
Assessment of electrocardiographic ischemia in hypertensive patients treated with isradipine or placebo.
A total of 203 patients with hypertension ( supine diastolic blood pressure of 100 - 119 mm Hg ) from six centers entered into a 3-week placebo baseline followed by 5 weeks of active treatment ( either placebo or isradipine 2.5 , 5 , 7.5 , or 10 mg BID ) to determine the effectiveness of isradipine on blood pressure control . Electrocardiographic criteria for left-ventricular ischemia were coded blindly using the Minnesota Codes 4 - 1 to 4 - 4 and 5 - 1 to 5 - 3 at the end of baseline and active treatment periods . One hundred seventy patients with hypertension and matching and complete electrocardiograms completed the study for analysis : 63 ( 37 % ) were white and 117 ( 69 % ) were men . They were 52.1 + /- 10.3 years old mean + /- SD ; range : 22 - 77 years ) . No myocardial infa rct ion occurred during the active phase . Fifty-eight of 170 ( 34 % ) at baseline and 54 of 116 ( 32 % ) at week 5 had left atrial enlargement . Romhilt-Estes left-ventricular hypertrophy was not significantly different at baseline versus active treatment : 14 of 170 ( 8.2 % ) versus 15 of 170 ( 8.8 % ) . At baseline , the rate of active ischemia was 28.2 % ( 48/170 ) : 27.8 % ( 10/36 ) were r and omized to receive placebo during active treatment and 28.4 % ( 38/134 ) were given isradipine ( P = NS ) . For those without ischemia at baseline , the rate of change to electrocardiographic ischemia during active treatment was 0 % ( 0/26 ) for those receiving placebo and 3.1 % ( 3/96 ) for those taking isradipine ( P = NS ) . For those with ischemia at baseline , the rate of change to no ischemia during active treatment was 20 % ( 2/10 ) for those receiving placebo and 10.5 % ( 4/38 ) for those taking isradipine ( P = NS ) . ( 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 .