ISBA
ASH XI ABSTRACTS
AJH-APRIL 1996--VOL. 9, NO.4, PART 2
F73
F74
THE IMPACT OF LACIDIPINE ON CARBOHY. ORATE AND LIPID METABOLISM. C Spieker·, M Barenbrock, W Zidek. Med. Univ.-Poliklinik Munster, Germany In an open multicenter study the Ca2 + antagonist, lacidipine was tested for efficacy and safety, especially with respect to lipid and carbohydrate metabolism. The study was performed in 2127 patients with essential hypertension. The patients were treated with lacidipine orally in a dosage of 2 - 6 mg daily for 48 weeks. Whereas lacidipine decreased blood pressure significantly by 20.± 17 (systolic) and 14.± 10 (diastolic, both p <0.0001), there were no adverse effects on lipid and carbohydrate metabolism, neither in the total group nor in a subset of diabetic or hyperlipidemic patients. It is concluded that lacidipine is a safe and effective drug in the long-term antihypertensive treatment of patients with essential hypertension and with concomitant metabolic disorders such as diabetes mellitus or dyslipidemia.
SODIUM NITROPRUSSIDE VERSUS URAPIDIL IN THE TREATMENT OF HYPERTENSIVE CRISES. MM Hirsch", M
Key Words:
Antihypertensive Treatment Lipid and Glucose - Metabolism
Binder, A Bur, H Herkner, A Wagner, AN Laggner. Department of Emergency Medicine, Universdy of Vienna, AustJia, Europe. Whereas urapldil, a peJipherel alph.b1ocker and a central serotonin-agonist, Is the drug of choice In the treatment of hypertensive crises In Europe, sodium nitroprusside Is the preferred drug in the States. As urepldil Is still an investigational drug In the States, studies compaJing safely and efficacy of both drugs in patients with hypertensive crises are rere. 80 patients with hypertellSlve emergencies (diastolic blood pressure >110mmHg and evidence of eDd-organ damage) were randomized to the study prolocol. Response to treatment was defined as a reduction of diastolic blood pressure < 110 mmHg and release of symptoms within 110 minutes after start of treatment. 12.5 mg urapldil was applicated intravenously every 15 minutes until goal of treatment was achieved (maximum dose: 75 mg). Infusion of sodium nitroprusside started with 0.5 IJQ!kglmin and wes increased ervery 15 minutes by 0.5 Illl until blood pressure reduction was sufficient (maximum dose: 8 IJQ!kglmin). Severe side-effects were defined as dISCOntinuation of the drug due to severe hypotension (systoliC blood pressure <100mmHg), clinical signs of carebral or coronary !fusion or volume subst~ution h URAPIDIL NITROPRUSSIDE
83 100 SIDE-EFFECTS 25 125 001 Companng both drugs a Significant hiQher response rate has been observed In patients receiving nltroprussKle. However, the use of sodium nitroprusside Is associated with • considerable percentage of severe side-effects. Therefore, In patients with Ischemic stroke, especially elderly people, n~roprusside should be used cautiously. In contrast, urapldd Is • safe and highly effective drug, which can be used In all kinds of hypertensive emergencies. Key Words:
urapldll, sodium nitroprusside, hypertensive crisis
F75
F76
SIMILAR EFFECTS OF 3 MONTHS TREATMENT WITH LOSARTAN AND ENALAPRIL ON ALBUMINURIA. BLOOD GLUCOSE AND LIPIDS IN PATIENTS WITH ESSENTIAL HYPERTENSION. Smen Nielsen. lens Dollerup and Carl Erik Mogensen'. Medical Department M, Aarhus Kommunehospital, Aarhus & Merck Research Laboratories, Copenhagen, Denmark. In a double-blind, randomized, double-dummy, comparative, 12 weeks study we evaluated the effects on Enalapril (E) 20 mg daily (n =46) versus the angiotensin II receptor blocker Losartan (L) 50 mg daily (n =47) on blood pressure, albuminuria, and blood glucose and lipids in 93 patients with essential hypertension (57 males, 36 females, age 53 (9) years (mean (SO», BMI 27.5 (4.1) kg/mZ), normal serum creatinine and without proteinuria (urinary albuminlcreatinine ratio (Ualb/cr) < 20 mg/mmol). Blood pressure was similarly reduced by both treatments (E: from 157/103 (1615) (mean (SO) to 144/94 (17m mm Hg; L: from 158/103 (16/6) to 147/94 (1919) mm Hg, both p
ENALAPRIUHCTZ 20/6 MG REDUCES ALBUMINURIA IN PATIENTS WITH ESSENTIAL HYPERTENSION. AN ATENOLOL CONTROLLED 3 MONTHS STUDY. Seren Nielsen, lens Dollerup and Carl Erik Mogensen'. Medical Department M, Aarhus Kommunehospital, Aarhus &. Merck Research Laboratories. Copenhagen, Denmark. Elevated urinary albumin excretion (UAE). a common feature of essential hypertension, may be reduced by ACE inhihition through independent reductions of syslemic and/or intraglomerular hypertension. We enrolled 175 patients with essential hypenension (aged 51 (9) years (mean (SO)), BMI 27.7 (4.0) kg/m') with normal serum creatinine and without proteinuria (urinary albumin/creatinine ratio (Ualb/cr) < 20 mg/mmol) in a doubleblind, randomized, double-