An open clinical trial was conducted to evaluate the efficacy and tolerability of isradipine in 30 cases (male 16, female 14 cases, average age 52.6+/-7.94) of mild to moderate essential hypertension using 1.25-2.5mg twice a day for 8 weeks of active treatment. Blood pressure was significantly reduced from 168.5+/-14.33/108.3+/-6.37mmHg, 163.7+/-9.74/105.5+/-7.1mmHg to 141.0+/-13.69/92.0+/-9.27mmHg, 138.8+/-13.46/92.3+/-11.16mmHg in sitting and standing position respectively. The extent of reduction was 27.5/16.3mmHg in sitting position and 29.9/13.2mmHg in standing position. This comprised the mean response rate in terms of reduction of DBP of 10mmHg or more being 90% and the normalization rate, deficed as DBP lowering to 90mmHg or below, being 70%. Heart rate, hematology and blood chemistry including blood sugar and lipids were not changed significantly after treatment with isradipine. No significantl side effect was observed except 2 cases of mild transient facial flushing and nausea during the treatment, so could proceed the trial without drug discontinuation in all 30 cases. The results suggest that isradipine is one of the useful and safe drugs in the treatment of mild to moderate essential hypertension.
Blood Glucose ; Blood Pressure ; Chemistry ; Female ; Flushing ; Heart Rate ; Hematology ; Humans ; Hypertension* ; Isradipine* ; Nausea

BACKGROUND: Antihypertensive treatment represents the modification of one of the most important risk factors on the development of cardiovascular, cerebrovascular and peripheral vascular disease. In cases of markedly developed atherosclerosis, reduction of blood pressure can improve the survival of patients by reducing the incidence and/or severity cerebrovascular events. We studied a new dihydropyridine calcium antagonist isradipine to evaluate the efficacy and safety in patients with essential hypertension. METHOD: After a placebo run-in phase of four weeks duration, 2.5mg isradipine once daily orally was administered for four weeks to 84 patients (48 males, 36 females ; mean age ; 50.8 years). And then 5.0mg isradipine once daily was administered for four weeks to 59 patients whose diastolic pressure did not decrease less than 90 mmHg. RESULTS: 1) At the end of 8 weeks of therapy, systolic and diastolic blood pressure were significantly reduced from 158.2+/-11.5/101.7+/-5.1mmHg in sitting, 156.8+/-13.7/102.3+/-5.6mmHg in standing to 138.3+/-13.8/90.1+/-6.7mmHg in sitting, 137.6+/-13.7/91.2+/-7.6mmHg in standing (p<0.001). And the effectiveness rate was 84.3% in sitting, 83.2% in standing and normalization rate below 90mmHg in diastolic pressure was 67.5% in siting and 61.5% in standing position. 2) The sitting and standing pulse rate did not change significantly (72.7+/-7.4beats/min at baseline vs. 73.4+/-6.8 beats/min after 8 weeks trial in sitting, 73.5+/-7.2beats/min at baseline vs. 74.1+/-7.2 beats/min after 8 weeks trial in standing). 3) The reduction of mean systolic and diastolic blood pressure at the end of 8 weeks were 19.9/11.6mmHg in sitting and 19.2/11.1mmHg in standing. 4) At the end of 8 weeks the successes of therapy in sitting were 67.5% in excellent, 10.8% in good, and 6.0% in fair response. 5) There was no serious side effect except mild symptom of 5 cases(5.9%) of exertional dyspnea and one episode of (1.2%) tachycardia. CONCLUSION: These results indicate that isradipine is effective and safe antihypertensive agent in the treatment of essential hypertension.
Atherosclerosis ; Blood Pressure ; Calcium ; Dyspnea ; Female ; Heart Rate ; Humans ; Hypertension* ; Incidence ; Isradipine* ; Male ; Peripheral Vascular Diseases ; Risk Factors ; Tachycardia

Essential hypertension is an important public health problem in Korea-being common, asymptomatic, easily treatable, and often leading to lethal complication in left untreated. The number of patients with hypertension has been significantly increased, and this factor may be an importnat one responsible for the increase in cardivascular mortality during past 20 years in Korea. As the drug therapy for hypertension needs longer period, it is very important to evaluate the efficacy and the adverse effects. Thirty patients(17 men and 13 womon) with essential hypertension were evaluated in this study. All patients had received oral Isradipine 1.25~2.5mg b.i.d. for 8 weeks. 1) The systolic and diastolic pressure were decreased significantly(166.8+/-9.0mmHg vs 147.3+/-12.0mmHg, p<0.001 and 100.3+/-4.0mmHg vs 90.3+/-6.1mmHg, p<0.001, respectively) 2) Heart rate, body weight, laboratory tests, chest X-ray, ECG studies were not changed significantly. 3) The systolic pressure was lowered by 20mmHg or more in 17 cases(56.7% of total), and the diastolic pressure was lowered by 10mmHg or more in 20 cases(66.7% of total) at 8 weeks after Isradipine administration. 4) The adverse effects of Isradipine were edema in 3(10%), constipation in 2(6.7%), headache in 2(6.7%), and insomnia, dizziness and dry mouth in 1 patient respectively, and none of them discontinued Isradipine administration due to adverse effects. In many patients with essential hypertension there is an effective response to Isradipine, even though there may be some mild adverse effects.
Blood Pressure ; Body Weight ; Constipation ; Dizziness ; Drug Therapy ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension ; Isradipine ; Korea ; Male ; Mortality ; Mouth ; Public Health ; Sleep Initiation and Maintenance Disorders ; Thorax

Felodipine is a calcium channel blocker that is used in the management of hypertension. Calcium channel blockers, along with phenytoin and cyclosporin, are implicated as a cause of gingival hyperplasia. Calcium channel blockers associated with this undesired side-effect include nifedipine, nicardipine, isradipine, amlodipine, felodipine, verapamil, and diltiazem. Several cases of adverse gingival hyperplasia related to felodipine have been reported since 1991, although no case has been reported in Korea. We report a case of gingival hyperplasia in a 55-year-old man on long-term felodipine.
Amlodipine ; Calcium Channel Blockers ; Calcium Channels ; Cyclosporine ; Diltiazem ; Felodipine ; Gingival Hyperplasia ; Humans ; Hypertension ; Isradipine ; Korea ; Middle Aged ; Nicardipine ; Nifedipine ; Phenytoin ; Verapamil

Dihydropyridine (DHP) calcium channel blockers (CCBs) have been widely used to treat of several cardiovascular diseases. An excessive shortening of action potential duration (APD) due to the reduction of Ca2+ channel current (I(Ca)) might increase the risk of arrhythmia. In this study we investigated the electrophysiological effects of nicardipine (NIC), isradipine (ISR), and amlodipine (AML) on the cardiac APD in rabbit Purkinje fibers, voltage-gated K+ channel currents (I(Kr), I(Ks)) and voltage-gated Na+ channel current (I(Na)). The concentration-dependent inhibition of Ca2+ channel currents (I(Ca)) was examined in rat cardiomyocytes; these CCBs have similar potency on I(Ca) channel blocking with IC50 (the half-maximum inhibiting concentration) values of 0.142, 0.229, and 0.227 nM on NIC, ISR, and AML, respectively. However, ISR shortened both APD50 and APD90 already at 1 microM whereas NIC and AML shortened APD50 but not APD90 up to 30 microM. According to ion channel studies, NIC and AML concentration-dependently inhibited I(Kr) and I(Ks) while ISR had only partial inhibitory effects (<50% at 30 microM). Inhibition of I(Na) was similarly observed in the three CCBs. Since the I(Kr) and I(Ks) mainly contribute to cardiac repolarization, their inhibition by NIC and AML could compensate for the AP shortening effects due to the block of I(Ca).
Action Potentials ; Amlodipine ; Animals ; Antihypertensive Agents ; Arrhythmias, Cardiac ; Calcium Channel Blockers* ; Calcium Channels* ; Calcium* ; Cardiovascular Diseases ; Inhibitory Concentration 50 ; Ion Channels ; Isradipine ; Myocytes, Cardiac ; Nicardipine ; Purkinje Fibers ; Rats