Central hemodynamic effects at rest and during exercise of acute and chronic treatment with nisoldipine in essential hypertension

Abstract

The acute and chronic hemodynamic effects of nisoldipine were studied in 19 patients (17 men, 2 women; mean age 43 years) with essential hypertension at rest supine and sitting and during steady state 100 W bicycle exercise. At rest supine, the first dose response (1 h) was reduction of intraarterial (IA) pressure (9%) and total peripheral vascular resistance (TPR; 19%) and rise in heart rate (HR; 9%) and cardiac output (CO; 12%). Thereafter, the effect leveled off: at 3 h, IA pressure, CO, and TPR were reduced 6%, 1%, and 4%, respectively. Similar results were seen at rest and during exercise. After 1 year treatment, the changes were more marked: at rest, IA pressure and TPR fell (16% and 20%, respectively) while stroke volume and CO rose slightly (4% and 6%, respectively). There was no reflex tachycardia. During 100 W exercise, IA pressure fell (14%) due to reduction both in TPR (7%) and CO (6%). Thus, at rest, nisoldipine lowers blood pressure by reduction of TPR both acutely and chronically. The initial rise in CO is lost after long-term therapy. During exercise, falls in both TPR and CO contribute to the hypotensive effect.