Abstract
There are many reports on the efficacy of Ca-antagonists for treatment of elderly essential hypertension. In particular, many studies have noted the beneficial effects of antihypertensive therapy on the quality of life (QOL). Nevertheless, there are no reports on antihypertensive therapy regarding the relationship between brain blood flow (BBF) and QOL. Therefore, we examined the efficacy of nitrendipine, a Ca-antagonist, on the brain blood flow and QOL, and its side effects in elderly essential hypertensive patients. The subjects were 17 (males: 4, females: 13) patients with untreated hypertension of WHO stage I or II, aged 70 years or older. The mean dose of nitrendipine was 9.4 +/- 0.4 mg daily. Before and 6 months after treatment, we examined blood pressure (BP), heart rate (HR), echocardiography (left ventricular mass index [LVMI], % fractional shortening [% FS]), plasma noradrenaline (Nad), plasma renin activity (PRA), BBF using the IMP-ARG method with BBF scintigraphy, and QOL was examined with a questionnaire. Two patients were excluded from this study because 1 had no decrease in BP, and another was moved to a different hospital. BP significantly decreased from 178/93 to 137/77 mmHg, but HR was not changed after treatment. BBF significantly increased from 37.0 +/- 4.9 to 41.0 +/- 4.9 ml/dl/min, but % FS, Nad, and PRA did not significantly change. The degree of QOL was improved by 4.2 +/- 1.2 points and there was a significant positive correlation between the changes of BBF and of QOL (r = 0.66, p = 0.04). However, moderate pharmacotherapy for BP seems to be necessary because there were 2 patients whose BBF decreased accompanied by excessive drop in BP after treatment. In conclusion, it is possible to safely use nitrendipine for elderly essential hypertensive patients. Nitrendipine has beneficial effects on BBF, and it was suggested that the increase of BBF is one of the most important factors in improvement of QOL.
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Schedule a callMore From: Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
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