A controlled study of the effects of isosorbide mononitrate on arterial blood pressure and pulse wave form in systolic hypertension.

Abstract

OBJECTIVE:

To determine the effect of an extended-release nitrate preparation on the arterial pulse wave and blood pressure of patients in whom systolic blood pressure was elevated in part by exaggerated pulse-wave reflectance.

DESIGN:

A double-blind randomized placebo-controlled crossover study was carried out.

PATIENTS AND METHODS:

The subjects were ten elderly patients with systolic hypertension resistant to conventional anti-hypertensive therapy. Pharmacodynamic responses to 2-week courses of placebo/isosorbide mononitrate (ISMN) were assessed in seven subjects by an ambulatory blood pressure monitor, and in all ten subjects by standard sphygmomanometry, arterial pulse-wave analysis and measurement of plasma nitrate concentration during peak and trough.

RESULTS:

Ambulatory systolic blood pressure was decreased by ISMN (P < 0.02) between 1000 and 2200 h. Ambulatory diastolic blood pressure fell with ISMN (P < 0.01) during the last 4 h of this period. At peak plasma nitrate levels, ISMN decreased the aortic systolic blood pressure (P < 0.01), ejection peak (P < 0.02) and augmentation component (P < 0.001) of the pulse wave; heart rate increased slightly (P < 0.03).

CONCLUSION:

ISMN has a role as an adjunct in the anti-hypertensive therapy of patients with refractory systolic hypertension due to exaggerated pulse-wave reflectance.

• Authors: G S Stokes, M Ryan, A Brnabic, G Nyberg
• Journal: Journal of hypertension (J Hypertens) Vol. 17 Issue 12 Pt 1 Pg. 1767-73 (Dec 1999) ISSN: 0263-6352 [Print] England
• PMID: 10658944 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Vasodilator Agents
• Isosorbide Dinitrate
• isosorbide-5-mononitrate

Topics

• Aged
• Blood Pressure (drug effects)
• Cross-Over Studies
• Diastole (physiology)
• Double-Blind Method
• Female
• Humans
• Hypertension (drug therapy, physiopathology)
• Isosorbide Dinitrate (administration & dosage, analogs & derivatives, blood)
• Male
• Systole (physiology)
• Vasodilator Agents (administration & dosage, blood)