Effect of controlled-release nifedipine on left ventricular hypertrophy in Japanese patients with hypertension: An open-label, uncontrolled study
Masaki ShimoyamaHiroshi OchiShin’ichi TakedaTetsuya DoiYoshiharu KinugasaAkihiro EndohToru KinugawaKazuhíde OginöIchiro HisatomeChiaki ShigemasaIssei Komuro
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Tolerability
Brain natriuretic peptide
Objective To study the relationship between brain natriuretic peptide(BNP) and left ventricular hypertrophy(LVH) in essential heypertensives(EH) and the level of BNP before and after treatment with ARB.Methods Echocardiography was performed to determine left ventricular mass index(LVMI) and E/ A ratio.Plasma BNP was measured by RIA in 63 cases of hypertension(mean age 57.2 ± 6.4 years) with 30 healthy subjects(mean age 54.3±5.8 years) served as control.The hypertensives with LVH were treated with Losartan Potassium Tablets 50-100mg/d for 40 weeks.Results Plasma BNP was significantly increased(P0.01) in hypertensives with LVH as compared with those without LVH and with health subjects.Losartan Potassium Tablets treatment significantly decreased plasma BNP and LVMI with LVH(P0.05),increased E/A ratio in EH with LVH(P0.01).The plasma BNP positively was correlate with LVMI and negatively with E/A ratio.Conclusion Plasma BNP reflects the left ventricular hypertrophy and cardiodiastolic function in hypertensives.
Brain natriuretic peptide
Losartan Potassium
Essential hypertension
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Objective:To study effects of losartan on level of brain natriuretic peptide(BNP) in patients with essential hypertension(EH) complicated left ventricular hypertrophy(LVH) and its significance.Methods:The 100 EH patients with normal left ventricular ejection fraction(LVEF) were selected,and there were 58 cases complicated with LVH and 42 pure EH cases.Another 50 healthy subjects were regard as healthy control group.Plasma levels of BNP were compared among the three groups.EH+LVH group were given losartan for six months,the changes of BNP level and left ventricular mass index(LVMI) were compared before and after treatment.Results: ① Plasma level of BNP of EH + LVH group was significantly higher than those of pure EH group and healthy control group [(62.21±9.70) pg/ml vs.(39.35±10.57) pg/ml vs.(13.89±5.34) pg/ml,P0.01];② Concentration of BNP was positively correlated with LVMI(r=0.44,P0.05);③ Compared with before treatment,there were significant decrease in plasma level of BNP [(62.21±9.70) pg/ml vs.(38.78±7.94) pg/ml] and LVMI [(128.71±12.64) g/m2 vs.(107.36±11.32) g/m2] in EH + LVH group after six-month treatment with losartan,P0.01 both.Conclusion:Losartan can significantly decrease level of brain natriuretic peptide and reverse left ventricular hypertrophy in patients with hypertension complicated left ventricular hypertrophy.
Brain natriuretic peptide
Essential hypertension
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Onabotulinumtoxin A (onabotA) has shown efficacy in chronic migraine (CM), with good tolerability and a low rate of adverse effects, most of them not severe. The aim of this study is to evaluate tolerability and adverse effects of onabotA in clinical practice and to analyze if there is a relationship between tolerability to treatment administration, adverse effects' (AEs) occurrence and clinical response. We included patients with CM that received treatment with onabotA for the first time. Tolerability to treatment was evaluated by a 0-10 numeric rating scale (0: worst possible, 10: optimal tolerability). We assessed the presence of AEs by using a standardized questionnaire. Treatment response was based on the 50 and 75% responder rate between weeks 20 and 24, compared with the baseline, according to headache diaries. We analyzed whether the tolerability was associated with a higher frequency of AEs or a higher probability of clinical response. We included 105 patients, 87.7% female, with an age of 43.9 ± 10.7 years. Mean tolerability was 7.8/10 and 7.2/10 in the first and second onabotA administration, respectively. AEs were reported by (first-second) 71.4-68.6% patients. The percentage of patients with a 50% response was 56.3%. There was no association between tolerability and AEs' occurrence or clinical response.
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Nitroglycerin (drug)
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Objective To study the effects of benazepril HCl on left ventricular diastolic function and serum brain natriuretic peptide(BNP)level in patients with essential hypertension.Methods According to the result of echocardiography,52 hypertension patients were divided into left ventricular hypertrophy group and non-left ventricular hypertrophy group.All patients had been given benazapril HCl for 20 weeks.BNP and echocardiography were done before and after the treatment.Results The parameters of left ventricular diastolic function of two groups were improved after the treatment with benazepril.DT decreased significantly(P0.05),E/A rate increased significantly(P0.05),DC increased significantly(non-LVH group P0.01,LVH group P0.05),serum BNP level in two groups decreased significantly(non-LVH group P0.05,LVH group P0.01).LVMI had no significant change(P0.05).After the management,the decrease of BNP was negatively related to the increase of E/A rate in both groups(no-LVH group r=-0.409,P0.05,LVH group r=-0.483,P0.01).Conclusions Not only can benazapril HCl improve left ventricular diastolic function but also lower BNP levels in patients with hypertension.The more serious the left ventricular diastolic dysfunction,the more the decrease of serum BNP level.Serum BNP level may serve as a therapeutic indicator for benazapril HCl treatment in hypertension patients with left ventricular diastolic disfuction.
Benazepril
Brain natriuretic peptide
Essential hypertension
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The authors studied the antihypertensive effect and tolerability of a new sustained‐release formulation of nifedipine 50 mg once a day, in comparison with nifedipine retard 20 mg twice a day in patients with mild or moderate primary arterial hypertension. Both treatments significantly lowered blood pressure with no difference in daily blood pressure profile. At steady state, the two drugs determined comparable plasma levels of nifedipine as measured immediately before the morning dose. After a 12‐month treatment, the new formulation of nifedipine still displayed satisfactory blood pressure control in both supine and standing positions, with no change in tolerability throughout the study. In conclusion, this new sustained‐release formulation of nifedipine has similar efficacy and tolerability to conventional treatment with nifedipine retard 20 mg twice a day.
Tolerability
Supine position
Essential hypertension
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Objective To study the correlation between the serum brain natriuretic peptide(BNP)levels,the left ventricular hypertrophy(LVH),and left ventricular diastolic function(LVDF)in patients with essential hypertention(EH).Methods 122 patients with EH and 36 control subjects were investigated by measuring the serum BNP level and the left ventricular mass index(LVMI),ratio of E/A was determined by two dimensional echocardiography.The correlation between the serum BNP and LVMI,ratio of E/A were analyzed.Results The serum BNP level in patients with EH were markedly higher than those in control subjects(P0.01),furthermore,the serum BNP level was significantly increased(P0.01)in hypertensive patients with left ventricular hypertrophy(LVH)as compared with those without LVH.The serum BNP positively correlated with LVMI in patients with EH and negatively correlated with ratio of E/A in patients with EH.Conclusion The extent of BNP increase is closely correlated to the LVH and LVDF,furthermore,the serum BNP level may be a marker for the hypertensive patients with LVH and left ventricular diastolic dysfunction.
Brain natriuretic peptide
Essential hypertension
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Objective To investigate the relationship of plasma level of brain natriuretic peptide(BNP)and left ventricular hypertrophy(LVH)in patients with essential hypertension.Methods The plasma level of BNP was measured with electrochemiluminescence immunoassay method in 32 hypertensive patients without left ventricular hypertrophy(LVH)(NLVH group),30 patients with essential hypertension with LVH(LVH group),and 30 healthy adults(control group).Doppler echocardiography was employed to determine left ventricular mass index(LVMI)and observe the correlation of plasma BNP level with LVMI.Results The plasma BNP level was significantly elevated in LVH group than that of NLVH group and control group(P0.01).The plasma BNP level was significantly higher in NLVH group than that of control group(P0.01).BNP level was positively correlated with LVMI in hypertensive patients with LVH(r=0.64,P0.01).Conclusion BNP level may reflex the degree of left ventricular hypertrophy in patients with essential hypertension.
Brain natriuretic peptide
Essential hypertension
Plasma levels
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Objective To investigate the relationship between the levels of brain natriuretic peptide(BNP)and left ventricular hypertrophy(LVH)in patients with hypertension,and to observe the changes of plasma levels of BNP and left ventricular mass index(LVMI)before and after treated with enalapril.Methods 70 patients with hypertension(mean age:71.0±10.4 years)were randomly divided into LVH group(n=30)and non-LVH group(n=40).In addition,30 healthy subjects(mean age:68.0±9.7 years)were enrolled as control group.The patients with hypertension were treated with enalapril 10~20 mg/d for 30 weeks.Echocardiography was performed to detect LVMI and E/A ratio,and the levels of plasma BNP were detected by RIA.Results The plasma BNP levels were significantly increased in LVH group,as compared with those in non-LVH group and health subjects(201.2±52.0 vs 91.4±22.6,37.2±14.3ng/L,P0.01).In LVH group enalapril significantly decreased plasma levels of BNP(201.2±52.0 vs 65.3±22.4 ng/L,P0.01),LVWI levels(142.7±21.5 vs 116.4±11.2g/m2,P0.01),and increased E/A ratio(0.6±0.3 vs 1.0±0.4,P0.05).The plasma levels of BNP were positively correlated with LVMI,however,which were negatively correlated with E/A ratio.Conclusion The plasma BNP levels can be used to assess the extent of left ventricular hypertrophy and diastolic function in patients with hypertension
Brain natriuretic peptide
Essential hypertension
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