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Latest & greatest articles for nifedipine
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Safety of nifedipine in patients with hypertension: a meta-analysis Safety of nifedipine in patients with hypertension: a meta-analysis Safety of nifedipine in patients with hypertension: a meta-analysis Stason W B, Schmid C H, Niedzwiecki D, Whiting G W, Caubet J-F, Luo D, Ross S D, Chalmers T C Authors' objectives To compare cardiovascular event rates in patients with mild or moderate hypertension who received nifedipine with active drug controls. Searching MEDLARS was searched from 1966 (...) to August 1995 using the MeSH 'hypertension' and 'nifedipine' as a textword. Studies published in English, French, Italian, German or Spanish were included. Current Contents (CD-ROM), and the bibliographies of retrieved articles were also searched. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) were included if they had a minimum of 10 patients, were published in a peer-reviewed journal or supplement to such a journal, and reported adverse events
Nifedipine: dose-related increase in mortality in patients with coronary heart disease Nifedipine: dose-related increase in mortality in patients with coronary heart disease Nifedipine: dose-related increase in mortality in patients with coronary heart disease Furberg C D, Psaty B M, Meyer J V Authors' objectives To assess the effect of nifedipine dose on mortality and to review the potential mechanisms of such an effect. Searching The authors do not provide details of the sources searched (...) or the strategies used. Study selection Study designs of evaluations included in the review All published randomised controlled trials (RCTs) of nifedipine in the secondary prevention of CHD for which mortality data were available, were included. Specific interventions included in the review Nifedipine at doses of 30, 40, 50, 60, 80 and 100 mg/day, to a maximum of 120 mg. Participants included in the review Patients with coronary heart disease (CHD). Of the 16 studies included, 12 included patients
Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function. Vasodilator therapy with nifedipine reduces left ventricular volume and mass and increases the ejection fraction in asymptomatic patients with severe aortic regurgitation.To assess whether vasodilator therapy reduces or delays the need for valve replacement, we randomly assigned 143 asymptomatic patients with isolated, severe aortic regurgitation and normal left ventricular systolic (...) function to receive either nifedipine (20 mg twice daily, 69 patients) or digoxin (0.25 mg daily, 74 patients).By actuarial analysis, we determined that after six years a mean (+/- SD) of 34 +/- 6 percent of the patients in the digoxin group had undergone valve replacement, as compared with only 15 +/- 3 percent of those in the nifedipine group (P < 0.001). In the digoxin group, valve replacement (in a total of 20 patients) was performed because of left ventricular dysfunction (ejection fraction < 50
Use of nifedipine in the hypertensive diseases of pregnancy Use of nifedipine in the hypertensive diseases of pregnancy Use of nifedipine in the hypertensive diseases of pregnancy Levin A C, Doering P L, Hatton R C Authors' objectives To review available data about the use of nifedipine to treat hypertension in pregnancy. Searching MEDLINE, Excerpta Medica and BIOSIS Previews were searched from 1984 onwards for studies published in the English language, using the headings 'nifedipine (...) ', 'hypertension in pregnancy', 'uteroplacental blood flow', 'maternal/fetal hemodynamics', 'pre-eclampsia' and 'pregnancy outcome'. Study selection Study designs of evaluations included in the review The authors do not provide any details of the designs of the included studies. Specific interventions included in the review Acute administration of nifedipine, either alone or in conjunction with other blood-pressure medications including hydralazine, methyldopa, labetalol, atenolol, or methyldopa plus atenolol
Comparison of enalapril and nifedipine in treating non-insulin dependent diabetes associated with hypertension: one year analysis. To compare the efficacy, safety, and tolerance of enalapril and nifedipine in hypertensive patients with non-insulin dependent diabetes.One year double blind follow up of patients randomly allocated to either enalapril or nifedipine with matching placebos for the alternative drug.Metabolic Investigation Unit, Hong Kong.102 patients were randomised: 52 to nifedipine (...) and 50 to enalapril. At baseline 44 patients had normoalbuminuria, 36 microalbuminuria, and 22 macroalbuminuria.Blood pressure, albuminuria, and parameters of renal function and glycaemic control.In patients who completed one year's treatment the median dose required by the nifedipine group (n = 49) was 60 mg/day; seven (14%) required additional diuretics. Of 41 patients given enalapril, 37 required the maximum dose (40 mg/day) and 27 (76%) required diuretics. At one year mean arterial blood
Comparison between perindopril and nifedipine in hypertensive and normotensive diabetic patients with microalbuminuria. Melbourne Diabetic Nephropathy Study Group. To compare the efficacy of angiotensin converting enzyme inhibition with calcium antagonism in diabetic patients with microalbuminuria.Randomised study of diabetic patients with microalbuminuria treated with perindopril or nifedipine for 12 months and monitored for one or three months after stopping treatment depending on whether (...) they were hypertensive or normotensive. Patients were randomised separately according to whether they were hypertensive or normotensive.Diabetic clinics in three university teaching hospitals.50 diabetic patients with persistent microalbuminuria. In all, 43 completed the study: 30 were normotensive and 13 hypertensive; 19 had type I diabetes and 24 had type II diabetes.For 12 months 20 patients were given perindopril 2-8 mg daily and 23 were given nifedipine 20-80 mg daily.Albumin excretion rate, blood
Interaction of citrus juices with felodipine and nifedipine. Six men with borderline hypertension took felodipine 5 mg with water, grapefruit juice, or orange juice. The mean felodipine bioavailability with grapefruit juice was 284 (range 164-469)% of that with water. The dehydrofelodipine/felodipine AUC ratio was lower, diastolic blood pressure lower, and heart rate higher with grapefruit juice than with water. Vasodilatation-related side-effects were more frequent. Orange juice had (...) no such effects. Six healthy men took nifedipine 10 mg with water or grapefruit juice; the bioavailability with grapefruit juice was 134 (108-169)% of that with water.
Efficacy of nifedipine and isosorbide mononitrate in combination with atenolol in stable angina. Many patients with angina pectoris whose symptoms are not completely controlled by beta-blockers are treated with several types of drugs, but it is not clear whether addition of a calcium-channel antagonist and/or a nitrate confers any advantage over beta-blockade alone. 18 patients receiving atenolol for stable angina pectoris completed a double-blind, randomised, crossover trial of atenolol (...) treatment plus placebo, isosorbide mononitrate, nifedipine, and mononitrate and nifedipine (triple therapy). The patients were assessed subjectively and by treadmill exercise testing and 24 h ambulatory electrocardiographic recordings at the end of each 4-week treatment period. There were no significant differences among the treatment periods in angina attack rates, glyceryl trinitrate consumption, exercise duration to onset of angina or 1 mm ST depression, or duration of symptomless ischaemia. Total
1991LancetControlled trial quality: predicted high
Prevention of high-altitude pulmonary edema by nifedipine. Exaggerated pulmonary-artery pressure due to hypoxic vasoconstriction is considered an important pathogenetic factor in high-altitude pulmonary edema. We previously found that nifedipine lowered pulmonary-artery pressure and improved exercise performance, gas exchange, and the radiographic manifestations of disease in patients with high-altitude pulmonary edema. We therefore hypothesized that the prophylactic administration (...) of nifedipine would prevent its recurrence.Twenty-one mountaineers (1 woman and 20 men) with a history of radiographically documented high-altitude pulmonary edema were randomly assigned to receive either 20 mg of a slow-release preparation of nifedipine (n = 10) or placebo (n = 11) every 8 hours while ascending rapidly (within 22 hours) from a low altitude to 4559 m and during the following three days at this altitude. Both the subjects and the investigators were blinded to the assigned treatment
beta blockade and intermittent claudication: placebo controlled trial of atenolol and nifedipine and their combination. To determine the effects of the beta 1 selective adrenoceptor blocker atenolol, the dihydropyridine calcium antagonist nifedipine, and the combination of atenolol plus nifedipine on objective and subjective measures of walking performance and foot temperature in patients with intermittent claudication.Randomised controlled double blind four way crossover trial.Royal (...) Hallamshire Hospital, Sheffield.49 patients (40 men) aged 39-70 with chronic stable intermittent claudication.Atenolol 50 mg twice daily; slow release nifedipine 20 mg twice daily; atenolol 50 mg plus slow release nifedipine 20 mg twice daily; placebo. Each treatment was given for four weeks with no washout interval between treatments.Claudication and walking distances on treadmill; skin temperature of feet as measured by thermistor and probe; blood pressure before and after exercise; subjective
Long term reduction in sodium balance: possible additional mechanism whereby nifedipine lowers blood pressure. To assess the changes in sodium excretion and sodium balance after withdrawal of long term nifedipine.Single blind, placebo controlled study in patients receiving fixed sodium and potassium intakes.Blood pressure unit of a teaching hospital in south London.Eight patients with mild to moderate uncomplicated essential hypertension who had been taking nifedipine 20 mg twice daily (...) for at least six weeks.Withdrawal of nifedipine and replacement with matching placebo for one week.Urinary sodium excretion and cumulative sodium balance, body weight, plasma atrial natriuretic peptide concentrations, plasma renin activity and aldosterone concentrations, and blood pressure.During nifedipine withdrawal there was a significant reduction in urinary sodium excretion (day 1: -62.7 mmol/24 h; 95% confidence interval -90.3 to -35.0) and each patient retained a mean of 146 (SEM 26) mmol sodium
Retardation of angiographic progression of coronary artery disease by nifedipine. Results of the International Nifedipine Trial on Antiatherosclerotic Therapy (INTACT). INTACT Group Investigators. 425 patients showing mild coronary artery disease (CAD) on arteriography were enrolled in a multicentre trial and randomised to treatment with nifedipine (80 mg/day) or placebo. The two groups were well matched for age, sex, and risk factors. 348 patients (82%) underwent repeat arteriography 3 years (...) later; 282 (134 nifedipine, 148 placebo) had received treatment throughout, but treatment had been stopped in 39 nifedipine-treated and 27 placebo-treated patients after average periods of 354 and 467 days. Computer-assisted measurements of arteriograms from all restudied patients (175 placebo, 173 nifedipine) showed no significant differences in the number or severity of lesions on initial arteriograms, or in the progression or regression of existing lesions over 3 years. In contrast, the number
Comparison of intravenous infusions of iloprost and oral nifedipine in treatment of Raynaud's phenomenon in patients with systemic sclerosis: a double blind randomised study. To compare the long term effects of short term intravenous infusions of iloprost with those of oral nifedipine in patients with Raynaud's phenomenon associated with systemic sclerosis.Double blind, placebo controlled, randomised group comparison.Dermatology outpatient clinic.Twenty three patients with Raynaud's phenomenon (...) to receive nifedipine, starting at 30 mg daily and increased to 60 mg daily after four weeks for another 12 weeks. Infusions of placebo were given in the same manner as the infusions of iloprost. One patient from each group withdrew because of social reasons and three patients receiving nifedipine withdrew because of side effects.Reduction in number, duration, and severity of attacks of Raynaud's phenomenon, reduction in number of digital lesions, increase in digital blood flow.Measurements were taken
Effects of nifedipine in achalasia and in patients with high-amplitude peristaltic esophageal contractions. We studied the esophageal effects of nifedipine in 20 patients with achalasia (20 mg sublingually) and nine patients with high-amplitude peristaltic esophageal contractions (nutcracker esophagus) (20 mg orally). In patients with achalasia, nifedipine decreased lower esophageal sphincter (LES) pressure by approximately 30%. In ten patients with achalasia, plasma nifedipine concentrations (...) were 45.3 +/- 17.7 and 57.4 +/- 12.8 ng/mL (means +/- SEM) at 30 and 60 minutes, respectively, after drug administration. In patients with nutcracker esophagus, nifedipine decreased LES pressure by approximately 50% and contraction amplitude in the body of the esophagus by approximately 25%. After comparison was made with our previous results in normal subjects, we concluded that (1) nifedipine decreased LES pressure in patients with achalasia to a similar extent to that noted in normal subjects
Cigarette smoking and the treatment of angina with propranolol, atenolol, and nifedipine. To determine whether cigarette smoking affects the results of drug treatment for angina, we studied 10 cigarette smokers with angina who were given placebo, nifedipine (60 mg per day), propranolol (240 mg per day), and atenolol (100 mg per day), each for one week. The four-week double-blind study was repeated with the same randomly determined order of drug sequences, after all 10 subjects had stopped (...) the results of 48-hour ambulatory monitoring remained unchanged. The improvement after patients stopped smoking was greater during treatment with nifedipine than during administration of the other two drugs or placebo. Blood levels of propranolol were increased when patients stopped smoking; levels of nifedipine and atenolol were unchanged. Our data show that smoking had direct and adverse effects on the heart and interfered with the efficacy of all three anti-anginal drugs, but with nifedipine the most.
Controlled trial of nifedipine in the treatment of Raynaud's phenomenon. 17 patients with moderate to severe Raynaud's phenomenon were entered into a 6 week randomised double-blind crossover study to compare the efficacy of nifedipine with that of placebo. Nifedipine significantly reduced the frequency of attacks and also the severity of attacks, which was assessed by the patients on a linear analogue scale. Patients gave nifedipine a significantly higher drug-effectiveness score than placebo (...) . Skin temperature recovery times were not affected by treatment with nifedipine. 12 of the patients regarded nifedipine as effective in reducing the frequency and severity of Raynaud's phenomenon.
Nifedipine in unstable angina: a double-blind, randomized trial. We assessed the efficacy of adding nifedipine to the conventional treatment of unstable angina in 138 patients in a prospective, double-blind, randomized, placebo-controlled trial. There was no difference between the two groups in the dose of conventional antianginal medication or in age, prior myocardial infarction, ejection fraction, or other risk factors. Failure of medical treatment (defined as sudden death, myocardial (...) infarction, or bypass surgery within four months) occurred in 43 of 70 patients given placebo and in 30 of 68 given nifedipine. Kaplan-Meier survival-curve analysis of the number and time dependence of treatment failures demonstrated a benefit of nifedipine over placebo (P = 0.03). The benefit was particularly marked in patients with ST-segment elevation during angina (P = 0.02). Side effects (transient hypotension or diarrhea) required withdrawal of the drug from four patients given nifedipine and from