We studied the safety and efficacy of intravenous nicardipine alone and in combination with oral captopril. Sixteen patients with essential hypertension received a single oral dose of captopril, 50 mg, to be certain that excessive hypotension would not occur. Nicardipine was given intravenously as a 2 mg bolus, followed by an infusion at a rate designed to lower the supine diastolic blood pressure at least 10 mm Hg; then oral captopril, 50 mg, or placebo was given. The next week, nicardipine was again infused, but the alternate oral treatment was given. Intravenous nicardipine reduced blood pressure from 156 ± 15 101 ± 5 mm Hg (mean arterial blood pressure 120 ± 6 mm Hg) to 140 ± 11 88 ± 4 mm Hg (mean arterial blood pressure 105 ± 5 mm Hg). When captopril was added to nicardipine, the mean arterial blood pressure fell an additional 8 mm Hg but the heart rate did not increase. The combination of angiotensin-converting enzyme inhibition and calcium channel blockade produces additive antihypertensive effects without additional reflex tachycardia.
ASJC Scopus subject areas
- Pharmacology (medical)