RESUMO
Left ventricular mass sometimes decreases during the treatment of hypertension. In a two-year open study, we investigated the ability of extended release (ER) felodipine (5 or 10 mg), plus chlorthalidone (25 mg), given once daily, to reduce left ventricular mass in 84 elderly patients with isolated systolic hypertension. Drug dosage was determined in an initial stepped-care titration phase lasting six weeks. Mean systolic blood pressure decreased after two years of treatment with 5 or 10 mg of felodipine (p < 0. 001) and the left ventricular mass index decreased too (p < 0.0001). One or two weeks after withdrawal of therapies, blood pressure returned to pretreatment values. We concluded that left ventricular mass can be reduced in elderly patients with isolated systolic hypertension and ventricular hypertrophy who receive felodipine 5-10 mg once daily. This treatment was generally well tolerated.
Assuntos
Anti-Hipertensivos/administração & dosagem , Felodipino/administração & dosagem , Hipertensão/tratamento farmacológico , Hipertrofia Ventricular Esquerda/tratamento farmacológico , Idoso , Distribuição de Qui-Quadrado , Clortalidona/administração & dosagem , Quimioterapia Combinada , Ecocardiografia , Feminino , Humanos , Hipertensão/fisiopatologia , Hipertrofia Ventricular Esquerda/fisiopatologia , Modelos Lineares , Masculino , Sístole , Resultado do TratamentoRESUMO
The antianginal efficacy of 240 mg sustained release verapamil once daily doses and 300 mg diltiazem was studied in 20 normotensive patients with chronic stable angina pectoris, using a randomized, double-blind crossover design. Patients received a blinded therapy of verapamil placebo and diltiazem placebo for six weeks than only sustained-release diltiazem (SRD) for a long-term phase of three weeks, after a two-week placebo baseline period. Symptom-limited bicycle exercise was longer with the verapamil (510+/-129.9 s) and diltiazem (540+/-124.6 s) than with placebo at baseline (396+/-152.2 s, P<0.005). Verapamil and diltiazem reduced the weekly rate of anginal attacks from 5.1+/-8.6 during placebo to 4.4+/-4.1 with verapamil and 1.9+/-3.2 with diltiazem (P<0.05). The antianginal effects of the two agents are probably mediated by reduction of myocardial oxygen demand at submaximal exercise. In addition, diltiazem appears to provide more symptomatic relief and reduces the weekly number of anginal attacks significantly more than verapamil. Therefore its once-daily administration simplifies the treatment schedule and should improve patients' compliance.