Hemodynamic response, safety, and efficacy of isradipine in the treatment of essential hypertension.

The hemodynamic response achieved by isradipine is balanced; there is a marked decrease in total peripheral resistance with no clinically significant tachycardia or cardiodepressant effect, no fluid retention (natriuretic/diuretic effect) or orthostatic reactions, whereas the blood flow to vital organs is preserved. The blood pressure-lowering effect of isradipine as monotherapy is dose dependent and has shown a greater efficacy than propranolol, hydrochlorothiazide, and prazosin, without an increase in adverse effects. Combination therapy with a beta-blocker is also safe and offers a useful additional reduction in blood pressure. Indeed, the side effects are no more frequent than with placebo (in doses below 10 mg daily); they are also dose dependent and appear to diminish with time. Isradipine's antiatherogenic effects and cardiac protection potential require further evaluation in clinical studies, but add an interesting aspect to the drug. Against this background, isradipine appears to be a useful addition to our therapeutic arsenal and has the potential to become the drug of choice in the treatment of hypertension.

RCT Entities:   Population Interventions Outcomes