Effects of the New Calcium Entry Blocker Isradipine (PN 200–110) in Essential Hypertension

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Abstract
In this double-blind cross-over study 16 patients with mild-to-moderate hypertension were treated with placebo and the dihydropyridine derivative, isradipine 5–10 mg twice daily. In the supine position isradipine reduced systolic (–18 mm Hg; p < 0.002) and diastolic (–15 mm Hg; p < 0.001) pressures, while heart rate was not changed; in the standing position, systolic (– 15 mm Hg; p < 0.002) and diastolic (– 14 mm Hg; p < 0.001) pressures decreased, whereas heart rate increased (+6 bpm; p < 0.05). Body weight and lower leg volumes remained unaltered, suggesting that isradipine did not cause fluid retention. On IS plasma angiotensin I (+40 pg/ml), angiotensin II (+ 14 pg/ml), and aldosterone (+4.1 ng/dl) rose. The intracellular Na+ and K+ concentrations and the transmembrane cation transport activities (Na+-K+ pump, Na+-K+ cotransport, Na+-Li+ countertransport), measured ex vivo in the erythrocytes of eight male patients, were not significantly influenced by isradipine. Hot flushes and facial erythema occurred more frequently (p < 0.05) on isradipine than on placebo. In conclusion, the new calcium entry blocker isradipine at a dose of 5–10 mg twice daily lowers blood pressure and is well tolerated in most patients with essential hypertension.