Nicardipine in the treatment of essential hypertension controlled 6-month-study comparing nicardipine with propranolol at rest and during exercise

Treatment of hypertension in athletes: an evidence-based review

Hypertension is the most common cardiovascular condition in adults. It is also very common in athletes. When lifestyle changes fail, medications may be needed for the treatment of hypertension. When choosing a drug for antihypertensive therapy, providers should choose an agent that has favorable effects on blood pressure and minimal detrimental hemodynamic change during exercise. Evidence supports that the medications with the most favorable effects are angiotensin-converting enzyme inhibitors, calcium channel blockers, alpha-blockers, and cardiac-selective beta-blockers. The effects of diuretics are less desirable, and nonselective beta-blockers should be a last choice for hypertensive patients who are physically active.

Antihypertensive effect of slow-release nicardipine. A placebo-controlled cross-over study

The magnitude and duration of the antihypertensive effect of slow-release nicardipine (SR-Nicardipine) have been compared with placebo in 36 uncomplicated essential hypertensives (diastolic BP 95 to 115 mm Hg after 1-month placebo washout). According to a double-blind, randomized, cross-over design they received SR-Nicardipine 40 mg b.d. and placebo for 1 month. At the end of each treatment period, blood pressure and heart rate were measured 12 h after the evening dose and 1, 2, 3 and 4 h after the morning dose. SR-Nicardipine significantly reduced systolic (SBP) and diastolic (DBP) blood pressure at each time after dosing. The absolute decrements peaked 4 h after dosing (-18.3 and -11.7 mm Hg, respectively) and more than 90% of the peak effect persisted 12 h after dosing, both for SBP and DBP. The heart rate was slightly increased by SR-Ni-cardipine. Adverse effects monitored with a check-list occurred in 31% of patients during SR-Nicardipine treatment and in 28% on placebo. Thus, SR-Nicardipine 40 mg b.d. has a maintained and significant antihypertensive effect lasting up to 12 h in essential hypertension.

New therapeutic modalities in hypertension: focus on a new calcium antagonist-nicardipine

A new generation of dihydropyridine calcium antagonists which are related structurally to nifedipine is undergoing clinical investigation. Among these newer agents. nicardipine and nimodipine have become available for clinical use. In controlled trials, nicardipine is superior to placebo and equal to other antihypertensive agents for the treatment of systemic hypertension. Nicardipine is associated with a low incidence of adverse effects that are related primarily to its peripheral vasodilatory actions. In addition, nicardipine appears to have little if any negative effects on myocardial contractility or conduction.