Effects of long-acting nifedipine on casual office blood pressure measurements, 24-hour ambulatory blood pressure profiles, exercise parameters and left ventricular mass and function in black patients with mild to moderate systemic hypertension

Abstract

Thirty-nine black patients with mild to moderate hypertension were treated for 1 year with various long-acting preparations of nifedipine, during which time serial changes in 24-hour ambulatory blood pressure (BP), exercise performance, left ventricular (LV) mass index and LV systolic function were evaluated. Mean 24-hour ambulatory BP decreased from 156 ± 15 99 ± 8 to 125 ± 10 79 ± 6 mm Hg at 1 year (p <0.0001). LV mass index decreased from 130 ± 40 to 114 ± 39 g/m 2 at 6 weeks (p <0.005) and to 95 ± 32 at 1 year (p <0.0001). There was a significant reduction in septal and posterior wall thickness from 11.0 ± 2.0 to 9.3 ± 2.0 mm (p <0.0001) and from 10.9 ± 2.0 to 9.3 ± 2.0 mm (p <0.005), respectively. Cardiac index and fractional shortening changed insignificantly from 2.9 ± 0.7 to 2.9 ± 0.6 liters/min/m 2, and from 35 ± 5 to 36 ± 6%, respectively. At 1 year, using a modified Bruce protocol, exercise time increased from 691 ± 138 to 845 ± 183 seconds (p <0.05); peak exercise and 1 minute post-effort systolic BP decreased from 240 ± 26 to 200 ± 21 mm Hg and from 221 ± 27 to 169 ± 32 mm Hg (p <0.05), respectively. It is concluded that in the treatment of black patients with mild to moderate hypertension, the marked and sustained antihypertensive action of long-acting nifedipine documented by 24-hour ambulatory BP monitoring is associated with LV mass regression with no adverse effect on cardiac function together with a reduction in exercise systolic BP and a prolongation of exercise time.