Effect of nifedipine GITS on left ventricular mass and diastolic function in severe hypertension

R. A. Phillips, M. Ardeljan, S. Shimabukuro, M. E. Goldman, D. L. Garbowit, H. B. Eison, L. R. Krakoff

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Treatment of severe hypertension is beneficial, but reversibility of target-organ damage has not been characterized. Serial studies were performed in 15 patients with severe essential hypertension (age of 56 ± 3 years, mean ± SEM) treated for 1 year with 60 to 150 mg/day of continuous-release nifedipine; 3 patients required 50 mg of chlorthalidone/day to lower diastolic blood pressure (BP) to <95 mm Hg. Left ventricular (LV) structure and function was evaluated with two-dimensional-directed M-mode echocardiography, digitized from videotape and analyzed blindly. BP was markedly reduced from 194 ± 8/115 ± 4 to 146 ± 4/88 ± 14 mm Hg (p < 0.0001) and maintained at this level for 1 year. Posterior wall and septal LV thickness, elevated at entry (12.9 ± 0.1 and 13.4 ± 0.1 mm), dropped steadily over 1 year into the normal range (10.0 ± 0.03 and 11.2 ± 0.1 mm, p < 0.001). LV mass index, above 95% for normals at entry, decreased by 19% at 6 months (129 ± 10 to 104 ± 7 g/m2, p < 0.01), and remained at this level at 1 year. LV fractional shortening rose steadily over 1 year from 34 to 42% (p < 0.02). Atrial natriuretic peptide, which reflects LV filling pressures, was markedly elevated at entry, but was significantly reduced by 6 months (76 ± 22 vs. 45 ± 14 pg/ml, p < 0.05). Sustained reduction of arterial BP with continuous-release nifedipine for 1 year normalizes LV mass, improves LV systolic function, and reduces circulating levels of atrial natriuretic peptide.

Original languageEnglish (US)
Pages (from-to)S172-S174
Number of pages3
JournalJournal of Cardiovascular Pharmacology
Volume17
Issue numberSUPPL. 2
DOIs
StatePublished - 1991

Keywords

  • Left ventricular diastolic function
  • Left ventricular mass
  • Severe hypertension
  • Sustained-release nifedipine

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

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