EFFECTS OF NITRENDIPINE AND LISINOPRIL ON BLOOD-PRESSURE AND SODIUM-EXCRETION IN CYCLOSPORINE-ASSOCIATED HYPERTENSION AFTER HEART-TRANSPLANTATION

Hypertension associated with ciclosporin A may be mediated by sodium a nd volume retention. Therefore, the effects of an antihypertensive the rapy (6 weeks) with nitrendipine (10-20 mg twice daily) or lisinopril (10-20 mg once daily) on office blood pressure, 24-hour ambulatory blo od pressure, and left ventricular function were evaluated in a randomi sed, double-blind cross-over trial in patients after heart transplanta tion. Nitrendipine and lisinopril were equally effective in lowering o ffice and ambulatory systolic and diastolic blood pressures. After an acute sodium load (210 mval/2 h i.v.), sodium excretion was significan tly increased during therapy with lisinopril but only slightly during nitrendipine, indicating that angiotensin-converting enzyme inhibition may improve the sodium-retaining state of heart transplant recipients associated with ciclosporin A.