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March 1, 1983HypertensionOpen Access

Hemodynamic and reflex responses to acute and chronic antihypertensive therapy with the calcium entry blocker nifedipine.

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Why the study?

Does nifedipine improve hemodynamic parameters and reflex responses in men with essential hypertension?

Population

11 men with essential hypertension (WHO I-II), mean age 38.2 ± 5.1 years.

Design

Cohort

Follow-up

6 weeks

Authors

WKWolfgang KiowskiHeart Failure / CardiomyopathyOBOsmund BertelUniversity Hospital of GenevaPEPaul ErnéInterventional Cardiology

Discussion

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Overview

Nifedipine may reduce BP without chronic sympathetic activation in essential hypertension; leaves open confirmation in randomized trials.

Key Points

  • To assess the hemodynamic, sympathetic, and renin-angiotensin responses to acute sublingual and chronic oral nifedipine administration in men with essential hypertension.
  • Enrolled 11 men (mean age 38.2 ± 5.1 years) with essential hypertension (WHO stage I–II).
  • Evaluated acute responses to sublingual nifedipine (10 mg) and chronic responses following 6 weeks of oral nifedipine (20 mg three times daily).
  • Measured intraarterial blood pressure, systemic and forearm hemodynamics, blood volume, plasma catecholamines, and plasma renin activity (PRA).
  • Blood pressure dropped from 156.2 ± 5.3/83.1 ± 4.6 mm Hg at baseline to 147.3 ± 5.4/76.5 ± 4.5 mm Hg at 30 minutes acutely (p < 0.01) and to 135.5 ± 4.4/69.7 ± 2.9 mm Hg after 6 weeks (p < 0.01).
  • Acute therapy reduced systemic vascular resistance index from 39.3 ± 4.3 to 30.3 ± 3.0 units·m² (p < 0.01), triggering temporary increases in heart rate, cardiac index, plasma norepinephrine, and PRA via baroreflex activation.
  • At 6 weeks, systemic vascular resistance index decreased further to 28.1 ± 1.5 units·m² without persistent sympathetic activation or changes in blood volume, reflecting baroreflex resetting.

Structured PICO

Does nifedipine improve hemodynamic parameters and reflex responses in men with essential hypertension?

P
Population
11 men with essential hypertension (WHO I-II), mean age 38.2 ± 5.1 years.
I
Intervention
Nifedipine 10 mg sublingually (acute) followed by nifedipine 20 mg three times daily for 6 weeks.
O
Outcome
Hemodynamic responses (blood pressure, heart rate, cardiac index, systemic vascular resistance index), plasma catecholamines, and plasma renin activitysurrogate

Nifedipine provides effective antihypertensive monotherapy by reducing systemic vascular resistance without causing chronic sympathetic stimulation or volume retention.

Cite This Study

Kiowski et al. (1983) studied this question.

synapsesocial.com/papers/6a8abb2d67170f8360679f5dhttps://doi.org/10.1161/01.hyp.5.2_pt_2.i70

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Plasma Noradrenaline Concentration and α-Adrenoceptor-Mediated Vasoconstriction in Normotensive and Hypertensive Man1981 · 39 citations
  2. 2Greater Antihypertensive Efficacy of the Calcium Channel Inhibitor Verapamil in Older and Low Renin Patients1982 · 97 citations
  3. 3Control plasma renin activity and changes in sympathetic tone as determinants of minoxidil-induced increase in plasma renin activity.1975 · 62 citations
  4. 4The renin system: Variations in man measured by radioimmunoassay or bioassay1972 · 383 citations
  5. 5The role of calcium in the control of renin release.1982 · 48 citations