Clinical study on antihypertensive effect trough to peak ratio of nifedipine GITS

Abstract

Abstract: Aim To explore the best way of calculating antihypertensive effect of nifedipine GITS on trough to peak ratio (T/PR), and smoothness index (SI) of the drug from ambulatory blood pressure monitoring (ABPM). Methods 32 cases of mild to moderate essential hypertension patients were enrolled and each was given 30 mg of nifedipine GITS once daily. ABPM was repeated for four weeks. ABPM data were analyzed statistically and T/PR calculated by both individual and whole group way. Results The casual blood pressure (CBP) and ABP were lowered by (24 ±12) / (12 ±8) mmHg and (14.5 ±3.9) / (11.2 ±3.0) mmHg. The T/PR by individual w ay was 0.65 ±0.23 for SBP and 0.66 ±0.25 for DBP, while by whole group way 0.62 for SBP and 0.68 for DBP. The smoothness index (SI), a new method for assessing the homogeneity of 24 hour blood pressure reduction by antihy pertensive therapy, was 3.74 for SBP and 3.77 for DBP after treatment. Conclusion Nifedipine GITS lowers blood pressure effectively and smoothly for 24 hours long. Antihy pertensive effects can be reflected by T/PR and SI.

Key words: hypertension, trough to peak ratio, blood pressure monitoring, ambulatory, smoothness index, nifedipine GITS

CLC Number:

R972.4

LI Yu-Jie, MAI Wei-Yi, ZENG Qun-Ying, LIAO Xiao-Xing, WANG Li-Chun, Chen Guo-Wei. Clinical study on antihypertensive effect trough to peak ratio of nifedipine GITS[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2001, 6(2): 138-141.

References

1 Proposed guidelines for the clinical evaluation of antihypertensive drug products(DRAFT) Rockville. Md: Federal Drug Administration Division of Cardio-Renal Drug Products, 1988:4
2 Elliott HL, Meredith PA. Trough peak ratio, clinically useful or practically irrelevant ? J Hypertens, 1995; 13: 279
3 Myers MG.Trough-to-peak ratio and 24hour blood pressure control: methodological issues. Am J Hyper tens, 1995; 8: 214
4 Omboni S, Fogari R, Palatini P, et al. Reproducibility and clinical value of the trough-to-peak ratio of the antihy pertensive effect. Evidence from the sample study. Hypertension, 1998;32:424
5 Mallion JM, Maitre A, de-Galldemaris R, et al. Use of ambulatory blood pressure monitoring in the management of antihy pertensive therapy. Drugs, 1992; 44 (suppl) 1: 12
6 Lipicky RJ. Trough peak ratio: the rationale behind the united states Food and Drug Administration recommendations. J Hypertens, 1994; 12(S8): S17
7 Meredith PA, Ellio tt HL. FDA guidelines on trough: peak ratios in evaluation of antihy pertensive agents. J Cardiovasc Pharmased, 1994; 23(S5): S26
8 Joint National Committee on Prevention, Detection, Evaluation,Treatment of High Blood Pressure. The Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure(JNCVI). Bethesda, Md: national Institutes of Health Publication.1997; 98: 4088
9 Kloner RA, Vetrovec GW, Materson BJ,et al. Safety of long-acting dihydropyridine calcium channel blockers in hypertensive patients. Am J Cardial. 1998; 81: 163
10 Alderman MH, Cohen H, Roque R, et al. Effect of longacting and short -acting calcium antagonists on cardiovascular outcomes in hyper tensive patients. Lancet.1997; 349:594
11 Wurdeman RL, Mooss AN, Mohiuddin SM,et al. Comparison of 24 hour ambula tory blood pressure date in hypertensive patients switched from nifedipine-GITS to nifedipine-CC. Pharmaco therapy. 1999;19:94
12 Parati G, Omboni S, Rizzoni D, et al. The smoothness index: a new, reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension. [J] Hypertens. 1998; 16(11): 1685

[1]	NING Sisi, ZHAO Yuhong, YAN Lei, TANG Minna, ZHANG Ningzhi, ZHANG Yongqiao, CUI Zhaoqiang. Controversies over the targets of controlling blood pressure in hyper- tensive patients with chronic kidney disease [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(4): 463-467.
[2]	SHEN Chang, AI Kelong, HU Changping. Research progress in the regulation of hypoxic pulmonary hypertension by hypoxia-inducible factor-1 signaling pathway [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(1): 114-120.
[3]	FU Hong, TIAN Lei. Individualized precision therapy for patients with ischemic stroke and hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(8): 870-876.
[4]	CHEN Wengang, YIN Qin, ZHANG Weiwei, ZHOU Lulu, KOU Wanqing, YUAN Xiaolong. Distributions of MTHFR gene polymorphism and its correlation with blood Hcy in patients with hypertension in southern Anhui province [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(7): 768-774.
[5]	ZHANG Ningzhi, ZHAO Yuhong, TANG Minna, ZHANG Yongqiao, NING Sisi, CUI Zhaoqiang. Application of chronopharmacology in the hypertension treatment [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 418-422.
[6]	CUI Sumei, CUI Zhaoqiang. Application of β-blockers for hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 423-427.
[7]	LI Yuanfang, CUI Zhaoqiang. Treatment of hypertension complicated with hyperuricemia [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 428-432.
[8]	XU Jianfei, LIN Li. Research progress in pharmacological and non-pharmacological treatments of hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 433-441.
[9]	KUAI Zheng, ZHANG Xiaoyi, ZOU Yunzeng. Angiotensin receptor neprilysin inhibitor in elderly with hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 442-445.
[10]	LIU Guijian, CHENG Kuan, ZHU Wenqing, GE Junbo. Progress of hypertension pharmacological treatment [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 446-449.
[11]	MENG Shi, WANG Zhongqun. Research progress on human immunodeficiency virus-associated pulmonary arterial hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(12): 1431-1440.
[12]	WANG Rui, PAN Jinjin, LI Hua, YUAN Yuhui. Research progress of melatonin on pulmonary hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(4): 444-448.
[13]	XING Kai, GONG Jinyu, LUO Jianquan. Advances on pharmacogenomics of diuretics-related adverse reactions [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(2): 204-212.
[14]	YE Peng, TAN Xing, LENG Yueqi, WANG Yangkai, WANG Weizhong. Current opinions and developments of non-pharmacological treatments of hypertension based on sympathetic nervous system [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(12): 1335-1343.
[15]	HU Xiaoyan, XU Qiuping. Application of levosimendan in severe patients after cardiac surgery [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(9): 1027-1032.