Nifedipineの急性降圧効果と循環動態

Abstract

In order to evaluate the acute antihypertensive and hemodynamic effects of nifedipine,53patients in sinus rhythm were subdivided into 5 groups according to diastolic blood pressure (DBP) and cardiac index (CI). Hemodynamic variables were obtained by impedance cardiography before and 30 minutes after 10 mg of oral nifedipine. Group N (healthy subjects) showed 10%reduction in total peripheral resistance index (TPR I),16% increase in CI and 15% increase in heart rate (HR) after nifedipine. Group HT-1 (hypertensive patients with normal cardiac output) showed 30% decrease in BSP and DBP,58% reduction in TPRI,16% increase in CI and 14% increase in HR. Group HT-2 (hypertensive patients with low cardiac output) showed 21% decrease in SBP,19% decrease in DBP,45% reduction in TPRI,17% increase in CI and 11% increase in HR. Group OMI-1 (old myocardial infarction patients with normal card iac output) showed 16% decrease in SBP,11% decrease in DBP,30% reduction in TPRI,11% increase in CI and 15% increase in HR. Group OMI-2 (old myocardial infarction with low cardiac output) showed 22% decrease in SBP, no change in DBP,30% reduction in TPRI,9%increase in CI and no change in HR. Cardiac function curves were obtained from the patients in lone atrial fibrillation and these curves shifted to the left and upward after administration of nifedipine.It is concluded that oral nifedipine is not only a effective drug to hypertensive patients but also a drug of choice afterload reduction in patients with congestive heart failure.