[Efficacy and tolerability of nicardipine retard and captopril in hypertension in the aged. Results of a multicenter study]. / Efficacia e tollerabilità della nicardipina retard e del captopril nell'ipertensione dell'anziano. Risultati di uno studio multicentrico.

The efficacy and tolerability of nicardipine retard and captopril were assessed in 174 over-60-year-olds suffering from slight or moderate essential hypertension. After 2-3 weeks of wash out the patients were randomly assigned to calcium antagonist (40 mg twice a day) or ace-inhibitor (25 mg twice a day) treatment which continued for 180 days. Monotherapy was combined with hydrochlorothiazide (12.5 mg/day) after 2 months in the event of an unsatisfactory reduction of arterial pressure in relation to basal values. Systolic and diastolic blood pressure was measured (1st and 5th Korotkoff's tone) at monthly intervals while lying and standing; heart rate was also measured using a palpatory method. Both nicardipine retard (no. 86) and captopril (no. 88) caused a significant reduction of clino- and orthostatic systolic and diastolic arterial pressure during the first two months of treatment. Respectively 70% and 51% of patients responded to treatment and the blood pressure reductions achieved using monotherapy remained unchanged during the course of the study. The association of hydrochlorothiazide resulted in a significant decrease in arterial pressure in non-responders, an effect which was observed with both nicardipine retard and captopril. No significant variation in heart rate was recorded between the two groups. Twenty-one patients in the nicardipine retard group and 16 in the captopril group suffered from slight to moderate side effects. Six patients dropped out of the nicardipine retard group and 15 patients out of the captopril group, an event for which side-effects were responsible in 1 and 3 cases respectively. In conclusion, nicardipine retard and captopril represent an efficacious form of treatment for geriatric hypertension and possess a satisfactory level of tolerability.

Multicentre clinical placebo-controlled study with buflomedil in the treatment of mild dementia of vascular origin.

A study was carried out in 73 male or female patients suffering from mild vascular dementia. The experimental protocol involved an initial run-in period (14 days) and subsequent double-blind, randomized treatment with 300 mg buflomedil or placebo given orally twice daily for 90 days. At the end of this treatment period, all patients received buflomedil for a further 90 days and, thereafter, patients received buflomedil or no further treatment for another 90 days. The efficacy of buflomedil was monitored using rating scales and neuropsychological tests. The findings of the study indicate that buflomedil improved the symptoms of vascular dementia; the most improvement was recorded in patients who had received buflomedil for the longest period. Inadequacy, cooperation, psycho-affective disorders, self-care and somatic complaints were positively influenced by buflomedil. The efficacy of buflomedil may be due to its effects on platelet aggregation and improvement in blood flow distribution to the ischaemic brain and oxygenation of brain tissue.