Effects of Isradipine on 24-h Blood Pressure, Left Ventricular Hypertrophy and Hemodynamics in Type II Diabetic Hypertensive Patients.

Abstract

The effects of 5 mg slow-release isradipine given once daily for both office-taken and monitored 24-h blood pressure, left ventricular mass and forearm hemodynamics have been evaluated by noninvasive methods for 6 months in 12 type II diabetic patients aged 40--60 years with concomitant arterial hypertension of mild to moderate degree. A significant reduction in both supine (from 164/96 to 146/85 mmHg) and standing blood pressure (from 164/100 to 143/89 mmHg) was observed at the end of the treatment period. A slight reduction was detected in walking blood pressure and a more marked reduction in sleeping blood pressure measured by an ambulatory blood pressure monitoring system, although the statistical significance was only approached because of the huge daily variability in blood pressure levels. A significant reduction in left ventricular mass index was detected by M-mode echocardiography (from 153 plus minus 72 to 122 plus minus 84 g/m(2) body surface area) without any impairment of left ventricular systolic function. Brachial artery compliance was not significantly increased (from 1.86 plus minus 0.7 to 2.21 plus minus 0.9 cm(4) center dot dyne(minus sign1) center dot 10(7)) and impedance slightly but nonsignificantly reduced (from 99.6 plus minus 52 to 65.7 plus minus 13 dyne(5) center dot cm(minus sign5) center dot 10(2)) by the treatment. These results show that long-term isradipine treatment reduces blood pressure values and left ventricular hypertrophy. However, the findings of this study need to be confirmed in a larger population sample in order to establish whether isradipine really improves the overall cardiovascular risk profile.