Isradipine vs propranolol in hydrochlorothiazide-treated hypertensives: a multicenter evaluation

Article Abstract:

Drugs that block the ability of adrenergic compounds such as epinephrine to stimulate the heart are commonly used to treat hypertension, or elevated blood pressure. Often these beta blockers are used together with diuretic compounds that increase the excretion by the kidneys of ions and water while decreasing blood pressure. In this experiment this standard form of treatment, a combination of the beta blocker propranolol hydrochloride and the diuretic hydrochlorothiazide, was used as the standard of comparison for a new drug, isradipine, also used with hydrochlorothiazide. Isradipine is classified as a calcium blocking agent and works to open small vessels. A group of 78 patients from four different medical centers were randomly selected for treatment with either the standard combination or with combined isradipine-hydrochlorothiazide. Both propranolol- and isradipine- treated groups responded similarly to treatment; reduction of blood pressure occurred as early as one week after initial treatment and continued throughout the treatment period. Isradipine in conjunction with hydrochlorothiazide is well tolerated, although the rate of adverse reaction was considerably greater with isradipine than with propranolol, 73 percent compared with 45 percent. However, this result is overstated due to the experimental procedure. Five patients each in the propranolol and isradipine groups stopped taking the medicine because of adverse reactions. The study shows isradipine to be effective and safe for patients in whom hypertension cannot be controlled by the use of a diuretic alone.

Product/Service Evaluation, Propranolol hydrochloride, Propranolol, Chlorothiazide, Isradipine (Medication), Esidrix (Medication)

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Calcium channel blockers: lessons learned from MIDAS and other clinical trials

Article Abstract:

Calcium channel blockers in the treatment of hypertension should only be used when other treatments fail. The Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) found that isradipine, which is a short-acting calcium channel blocker, was linked to a higher incidence of cardiovascular events such as heart attack and chest pain in a group of hypertensive patients. This confirms other studies of another calcium channel blocker, nifedipine. Others have shown these drugs to be associated with gastrointestinal bleeding and cancer.

Complications and side effects

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Final outcome results of the Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS): a randomized controlled trial

Article Abstract:

The calcium channel blocker isradipine may increase the risk of cardiovascular events such as heart attack, stroke and chest pain in people who take the drug for hypertension. Researchers used ultrasound to measure the change in atherosclerosis in the carotid arteries of 883 people with hypertension who took isradipine or hydrochlorothiazide. There was no difference in the progression of atherosclerosis over the 3-year study. However, the incidence of major and minor cardiovascular events was greater in the group taking isradipine.

Development and progression, Atherosclerosis, Hydrochlorothiazide

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