Antihypertensive therapy with the calcium channel blocker isradipine: An appropriate choice for the diabetic patient with hypertension
| Autor: | Alan O. Marcus |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Pharmacology
medicine.medical_specialty Isradipine business.industry medicine.drug_class Calcium channel blocker medicine.disease Filtration fraction Impaired glucose tolerance Blood pressure Endocrinology Internal medicine Diabetes mellitus Renal blood flow medicine Cardiology Glucose homeostasis Pharmacology (medical) business medicine.drug |
| Zdroj: | Current Therapeutic Research. 54:763-778 |
| ISSN: | 0011-393X |
| Popis: | Treatment of hypertension in diabetic patients or patients with impaired glucose tolerance requires a specialized approach. Such hypertensive, glucose-impaired patients often have multiple medical problems, possibly from common causes, such as renal impairment, atherosclerosis, electrolyte disturbance, neuropathy, or cardiac dysfunction. Antihypertensive therapy in these high-risk, medically compromised patients must reduce blood pressure while having a beneficial or neutral effect on the diabetic state and other coexisting diseases with possible catastrophic end points. Isradipine is a second-generation, dihydropyridine-type calcium channel blocker shown to be efficacious, safe, and well tolerated in the treatment of diabetic patients with hypertension. In clinical trials of patients with insulin-dependent or non-insulin-dependent diabetes mellitus, monotherapy with isradipine normalized blood pressure in a majority of patients with minimal adverse reactions and no clinically significant alteration of heart rate. More importantly, isradipine had either a neutral or a beneficial effect on glucose homeostasis and lipid metabolism. In studies of nondiabetic patients with hypertension, isradipine has been shown to facilitate renal function by decreasing renal vascular resistance, increasing renal plasma flow, and maintaining or improving glomerular filtration rate and filtration fraction. These physiological effects may benefit patients with coexisting diabetes and hypertension, in whom end-stage renal disease is a common consequence. Studies to evaluate the effects of isradipine on a number of parameters or conditions important to the diabetic patient, including serum lipids, atherosclerosis, and proteinuria, are currently in progress. |
| Databáze: | OpenAIRE |
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