Treatment of Severe Hypertension and Hypertensive Emergency with Nifedipine, a Calcium Antagonistic Agent : Pathophysiology of Hypertension and its Relation to the Choice of Antihypertensive Treatment

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Nifedipine, the Ca^<++> antagonistic coronary vasodilator, was administered by oral, sublingual and enema routes. 1) In 6 severe hypertensive patients (systolic pressure ⩾ 200 mmHg, diastolic ⩾120 mmHg), nifedipine, administered orally, induced prompt and reliable fall of arterial pressure (systolic pressure: -28% of control level, diastolic: -27%). 2) In 10 patients with hypertensive emergencies, including malignant hypertension, intracranial bleeding, hypertensive encephalopathy and acute hypertensive heart failure, sublingual and enema administration of nifedipine were performed with excellent hypotensive efficacy. 3) Pressure begun to fall within 5-15 min, 30 min and 30-60 min after sublingual (or dissolved), enema and oral (capsule), respectively, and reached its lowest levels in the next 10-20 min. The fall of pressure lasts for 2-4 hours. 4) In the combination of nifedipine with alpha-methyldopa, antihypertensive response in short-term was increased about +11% over nifedipine alone and lasted for 8 hours. In combination with beta-blocker (propranolol), hypotensive efficacy increased +39% over nifedipine alone, but the effective duration of this combination was the same as nifedipine alone. 5) Side effects, including dryness of the mouth and burning sensation in face and legs, were observed in few patients.
社団法人日本循環器学会の論文
1981-07-20