NISOLDIPINE-CC - EFFICACY AND TOLERABILITY IN HYPERTENSION AND ISCHEMIC-HEART-DISEASE

Nisoldipine is a second-generation dihydropyridine calcium channel blo cker (CCB). It is the most vascular selective of the currently availab le CCBs, and thus has the capacity to lower blood pressure without aff ecting the functioning of the myocardium and skeletal muscle, and with out producing any negative inotropic effects. Nisoldipine coat core (C C) is an extended-release formulation that allows nisoldipine to be re leased gradually over 24 hours, minimizing fluctuations in plasma conc entration and providing a good trough/peak ratio. It has a slow onset and long duration of action, and ambulatory blood pressure monitoring has demonstrated that its antihypertensive effect is maintained over 2 4 hours with no evidence of reflex tachycardia, hypotension, or sympat hetic neurohormonal activation and no effects on circadian variation. Studies in patients with hypertension have shown that nisoldipine CC p rovides reductions in blood pressure that are at least equivalent to t hose seen with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, and other CCBs, without deleterious effects on metabolic parameters. In particular, it has been found to be effective in elderl y patients and in black patients with severe hypertension. The DEFIANT studies have demonstrated that nisoldipine CC improves cardiac functi on and exercise tolerance in patients recovering from acute myocardial infarction, without increasing the risk of mortality compared with pl acebo. It also improves exercise performance in patients with stable a ngina pectoris. Nisoldipine CC is well tolerated in all groups of pati ents, with the most frequently reported side effects being headache an d peripheral edema, which are usually mild and transient.