124A
ASH XII ABSTRACTS
AJH-APRIL 1997-VOL. 10, NO. 4, PART 2
D76
D77
EFFECTS,ON BLOODPRESSUREAND CARDfWJA13iXlLAfCmSKWCMm
OF ADDINGOOXA20SINTO THE CURRENTHYPOTENStVETNESAPYIJ
PATIENTSWfTHNON-CONTROLLED
HYPERTENSION.
4Latms. LQr.h
““ME Garcia,F Gil,J Mird,A Soria,andJ VeWra. PJcazabaHypertension
Gmupi
Aimeria.Spain.
A laIue numberof hypertensive
patientsrsqukedrugmmbinatimstd
achievesatisfactcw
rwntrdoftbekblindpressure.
whichIsmesubjectofourstudy~
to assessthe efficxy of doxazosinin hypertensive
patienkfailingto achifwd
saUsfactory
ombd, by addingOto Uleinitialdreg.S4 mm cc+drdled
hypmemlve
patients(70%men) witi a Meanaoe(years)of 58,5* 9,9 (r=32-W)anda mean
duratimofhypedension
of5,8 years,mcsived2 m~dayofdoxansinfcr24 weeks
as anaddingtie!spy.Slmdpressurre
wasassessedat O,4, S, 12, 16, 20 cd 2/
weeksandbiochemical
atnlysesafterO, 12 and24 weeksof treatment.previous
bsabnentccmsisted
of:dium~ 15 (18,75%),b.ata.blodwrs
5 (6.25%),angiotsnsim
mnveding
enzymm
inhiblcm
41 (51.25%),csiduma“fa~ists 18(22.5%)andcdtmrs
1 (1.25%).Asshowm
intable botiSvstdica”ddlastdlcblocdmessure(SSP& DSP)
A COMPARISONBETWEENTHE EFFECTSOF fACIDIPINE
VS NIFEDIPINEIN HYPERTENSIVECRISIS.
UQLM.OQ*,L. Ribere,M.J.Adrian,M. Sanchez,E. Rodriguez,
M. Tomes.A. Coca’
---Departmentsof InternalMedicine,HospitalEsperifSant and
HoapitelClinic,Barcelona,Spain.
Objective: To compare the antihypertensiveefficacy and
Sciersbility
Ofasingleedminietrsfion of aqui~terd doses of LcD
(4 mg) verausNFD (20 mg) in the treatmentof hypertensive
urgencies.
OeelgnandMeUmde:Twenty-nine
asimptomstic
patients(9m,
20f) witha meanage of 55.03*11.19 yeareandbaselineDBP
of 120 mmHgor higherafterrestingfor30 minutes,nottaking
arttihypertensiva
drwgs
fbrthelast24 hourswererandomizedin
a aiftg!e-biind
fashionto LCD-t mg(15 patients)or NFD-20mg
(14petimta)ina eingledcee.BPandHRvmratekeneverythifty
minutesduringthe first8 hoursand subsequently
everytwo
hoursuntilmmpiete24 hoursof follow-up
witha semiautomatic
device.
ResulW BaselineBP valueswere similarin the twogroups
(LCD222.5i32.B/124.&tB.4ve
NFD215.9i20.6/128~7,7 mmHg
P=ns). Both dregs promotea significantdescent of SBP
(169.8ti7.8 vs 170.6i25.3 mmHg)and DBP (104,1f16 vs
102.8H2.4mmHg)aflereighthours.However,SBP (154.6*48
vs 190.6*IS.2 mmHg)and DBP (93.8U7.7 vs 117,2*11.4
mmHgp<O,LWI)
WIE significantly
higherinthe NFDgroupafter
24 hours dosing. Fourteen pstiants in the LCD group
eapertmented
a fallinBPhgherthan25°Aoffhe baselinevalue
both after 8 and 24 hourspoetdoee.Although10 patients
experimented
thesameresponse
intheNFDgroupafter8 hours
pmtdcee,only4 patientsmaintainedthesevalueset 24 hours.
One patient treated vdth NFD presented a transient
cembmveacular
iechemicattack30 minutesafterdose(BPfall
from 210/125 to 120/60 mmHg). No adveme effects wre
obeeweinthe LCDgroup,
Condueione:Wec&clude thetetequipctenf
singledosing,the
long-actingcalcium channel blocker Iecidipinewas more
effectivethanthe shott-ectingnifedipinein controllingblood
pressureand merdeiningthis BP reductionover B hoursin
essentialhypertensive
patientsWthhypertansiva
crisis.
,.,
.7.—,
Flnalcmmol
%Cmltm4
P.741mmm
,P291mmHg
. . . . . ... mm..” 1mmHg
37.5
12.5
5
2S78
50
., ,.
OmFkg
Dm~
.
1
-, ..,
1
1 CalbolofimfhSw
diasfdicbtcodpressure.AM, cwsed a slgdfica”tbase
in cbcieiterdati
biglywidelevels,thusreducing
theirovwdlcsrdiovasxzlar
isk. Ooxazcsin,
at si@e
dailydmseof 2 @day, administered
@tier wimme ihitialdtugto nciuimbotlsd
a
drugwmm
hyw~n~e Patiens.ishkahlyeffetive
andwslltctwated.Ilis tfwrefm
.xmlderktgin p+%naty
mm fcnfhsmanagement
of hypettenslc!a
notczm!mllsd
wim
slngbdmgmetapy.
Key Words:
doxazcsin,
adding
merapy,unmnbdlsd
BP,Cardlova.?atarrisk
D79
D78
L
T
KeyWords:
Hypertan~ crisis,hypertensive
urgencies,
lackf@te,nifedipine
E
O B
O
A
M
A
F
M. Lombardo,C.Alli*,M. Broccolino,S.Ferrari,G.Zaini,
L.Montemurro*, D. Zanni** and A. Pezzsno
Cardiology, *Division of
Medicine
2“Division
of
,’Vergani,,,**Health PhysicService. Niguarda- Ci Gmnda Hospital,
Milan, Italy
Reversal of cardiac hypenmphy by smi-hypenensive treatment
dependson hemodynamicandnon-hemodynamicfactors.
To comparethe effectsof an ace-inhibitorand a dihidropyridineon
left and right ventricularstmctureand function,24 mild to moderate
never treated hypenensives(23 males,mean age 46&3years) were
randomizedto receivefosenopril(20 mg daily)or andodipine(10 mg
daily) for 12 months.At baselinesnd subsequentlyat the end of the
third, sixth snd twelfth months, each patient underwent
cchocardiographyand non-invasive ambulatory blood pressure
monitoring.
Both dregs significantlyreducedbloodpressure,casusl or monitored
(P< O.01), and left ventricularmsss index (from 125H2 to 100+12
g/m2, P< O.02, with amlodipine; from 106*18 to 89+10 g/m2,
P< O.02, with fosenopril; P between drugs: NS). Free right
ventricukwWSII thickness was also lowered in both groups,
althoughonly significantlyhy amlodipine(from 8.0+2.1 to 6.4i0.8
mm, p<o.ol).
Neitherdmg elicitedmy increasein plasmaatrial natriureticpeptide
concentrationsand in hesn rate (clinicor monitored),in comparison
with hsseline,
Finally, with either treatmentthe rsductionin ventriculssmass wss
not associated with impairmentof systolicfunction,whereasa trend
towards an improvementof right snd left diastolic indices was
observed.
In conclusion,both andodipineand fosenoprilinduced similareffects
on hi-ventricularsnatomyand function,withoutaroussl of signs of
sympatheticstimulation.
Key words:
F
N
OOF MIBEFRADIL ON LEFT VENTRICULAR
T
THE EFFECTS
I
R
HYPERTROPHY
IN
PATIENTS WITH
ESSENTIALHYPERTENSION.c Hoecdund,
A Watt, M Wilkins,J Tertczer,
R Cifkcva,A Mimmn, E Lindbergand R Pordy.Stockhclm
HesrtCenter,Stockholm,Sweden.
ThisefudYWBSundertakento evaluatethe effectof tha novd,
eelectiveT-typesalciumchsnnelblocker,mibefredil(Mib], on
regreaaionof Ieftventricularhyparmophy
LLVHJovw 6 menths
of therapyin hyperfeneive
patientsand to comparethiseffect
to that of the bets-bicckw,atenolcl@’1). LVHwee eaemeed
by echecerdiogrephy;
e centralizedIaboretetywas utilizedfer
blinded readings to ensure quality and insistency.
Secondaryparametersincludeda mmparison between the
two treatmentson changefrombaselinebloodprmsttre(Bn
at trough.Followinga placeborun-in pwicd, patientswwe
randomizedto once daily treatmentwith eitttef 69 mg Mib
WI
of 50 mgAfn R4=3s).Forthosepatientswlmeeeitdng
diastolicBP did not normalize~80 mm I-@, tie does of
studydrugwee increasedto 100 mg and, if needed,23 mg of
hydrochlorothiezide
wee added.At the end of Ute 6 month
treatmentpwiod, the Mib group demonstrateda significant
11.1%reductionin LV [email protected]].Thiewee highw
than that seen in the Atn group (8.1%], etthough the
calculatedtreatmentdifferenceof 4.6% in fsvourof Mib did
notreachsfsfieticelsignificance.The Mib groupmenifmteda
largerdacreaeein troughBPthanthe Atn group,17.7/14.3VS.
11.0/10.7mm Hg, mapactivdy,with cmanpondinglyhigher
normalization
retae[61%VS.46%). Bothtreatmentswem wdl
tolerated,but them wee a noticeablylower inademoeof
advameew’Ite mneideredby the investigators
es potentially
relatedto tmetmentin the Mib groupC24* va 48.5%).It u
concluded that Mib is en effectin agent for inducing
regressionof LVHin hypertensive
patients.
Key
dmg treatmsnt,ventricularmsss, ventricularfunction
w
o
IS4befmdil,
atanold,Iaftvembiculerhypwtmphy,
w rasion, hypdeneion
U