Factors determining the response to calcium antagonists in hypertension

J Cardiovasc Pharmacol. 1988:12 Suppl 6:S109-13. doi: 10.1097/00005344-198812006-00027.

Abstract

Pharmacokinetic and pharmacodynamic variability account for the large interindividual differences in the antihypertensive response to treatment with a calcium antagonist. Using an integrated kinetic-dynamic model, the acute and chronic (4-6 weeks) responses to nifedipine (n = 14) and verapamil (n = 14) were characterized for individual hypertensive patients in terms of fall in blood pressure per unit drug concentration. The responsiveness to nifedipine, as the mean of the group, was -0.48 mm Hg/ng/ml following the first dose and -0.49 mm Hg/ng/ml after chronic dosing. The corresponding values for verapamil were -0.13 and -0.12 mm Hg/ng/ml, respectively. For nifedipine and verapamil, the responsiveness to the first dose was significantly correlated both with the height of the pretreatment blood pressure (p less than 0.001) and the responsiveness after 4-6 weeks of treatment (p less than 0.001). Parameters derived from an individual approach to concentration-effect analysis are useful for evaluating the determinants of response to calcium antagonists and form a potential basis for optimizing drug therapy in individual patients.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Blood Pressure / drug effects
  • Calcium Channel Blockers / pharmacokinetics
  • Calcium Channel Blockers / therapeutic use*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Nifedipine / pharmacokinetics
  • Nifedipine / therapeutic use
  • Sympathetic Nervous System / drug effects
  • Verapamil / pharmacokinetics
  • Verapamil / therapeutic use

Substances

  • Calcium Channel Blockers
  • Verapamil
  • Nifedipine