The purpose of this study was to test tolerance and the antihypertensive effect of nicardipine, a new calcium antagonist, in 31 elderly patients aged 57-95 years. The study was conducted as a double-blind trial. The patients were allocated randomly to either active or placebo treatment. Sixteen patients were given 10-30 mg of nicardipine three times a day (mean dose, 69.4 mg per day); 15 other patients received a matching placebo. After 4 weeks, nicardipine lowered mean blood pressure, and the changes in systolic and diastolic blood pressure were significantly greater in the nicardipine group than in the placebo group. Nicardipine was tolerated very well, and orthostatic hypotension was never observed. There was no change in heart rate. Plasma renin activity (PRA) was measured in eight patients. There was no correlation between PRA and the antihypertensive effect of nicardipine. A pharmacokinetic study performed in 15 elderly patients showed a fast rate of absorption and also higher plasma levels than those observed in hypertensive adults (mean age, 54 years). This trial demonstrates the effectiveness of nicardipine in elderly hypertensive patients.
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http://dx.doi.org/10.1111/j.1365-2125.1985.tb05154.x | DOI Listing |
Am J Emerg Med
January 2025
Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.
Introduction: Patients with heart failure exacerbation can present in a variety of ways, including sympathetic crashing acute pulmonary edema (SCAPE). Emergency physicians play a key role in the diagnosis and management of this condition.
Objective: This narrative review evaluates key evidence-based updates concerning the diagnosis and management of SCAPE for the emergency clinician.
Front Cardiovasc Med
December 2024
Department of Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Introduction: Based on office blood pressure (BP) values, hypertension is categorized into three stages: stage 1 (140-159/90-99 mmHg), stage 2 (160-179/100-109 mmHg), and stage 3 (≥180/≥110 mmHg). Malignant hypertension (MHT) is characterized by extreme BP elevation (systolic blood pressure above 200 mmHg and diastolic blood pressure above 130 mmHg) and acute microvascular damage affecting various organs, particularly the retinas, brain, and kidneys.
Objectives: The pathogenesis, predisposing variables, therapy, and preventive strategies for MHT were examined in this review.
Neurocrit Care
December 2024
Division of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
Neurocrit Care
December 2024
Department of Neurology, Albany Medical Center, Albany, NY, USA.
Intrathecal nicardipine (ITN) is an investigational therapy for cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). The objective of this scoping review was to characterize the current state of the literature and map the current available evidence, examine research methodology, clarify key concepts and definitions in the literature, report procedural characteristics, identify and analyze knowledge gaps, and serve as a precursor for future systematic reviews, meta-analyses, and randomized controlled trials. An electronic search for studies on ITN for the treatment of CVS and DCI in patients with aSAH was conducted in accordance with published standards.
View Article and Find Full Text PDFJACC Case Rep
December 2024
Department of Internal Medicine, University of California-San Francisco School of Medicine, San Francisco, California, USA.
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