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      Reversal of Left Ventricular Hypertrophy following Once Daily Administration of Felodipine for Two Years to Elderly Subjects with Isolated Systolic Hypertension


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          Left ventricular mass sometimes decreases during the treatment of hypertension. In a two-year open study, we investigated the ability of extended release (ER) felodipine (5 or 10 mg), plus chlorthalidone (25 mg), given once daily, to reduce left ventricular mass in 84 elderly patients with isolated systolic hypertension. Drug dosage was determined in an initial stepped-care titration phase lasting six weeks. Mean systolic blood pressure decreased after two years of treatment with 5 or 10 mg of felodipine (p < 0.001) and the left ventricular mass index decreased too (p < 0.0001). One or two weeks after withdrawal of therapies, blood pressure returned to pretreatment values. We concluded that left ventricular mass can be reduced in elderly patients with isolated systolic hypertension and ventricular hypertrophy who receive felodipine 5–10 mg once daily. This treatment was generally well tolerated.

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          Determinants of isolated systolic hypertension.

          Isolated systolic hypertension (ISH), defined as systolic blood pressure of 160 mm Hg or greater when the diastolic pressure is less than 95 mm Hg, is a common form of hypertension among the elderly. We collected incidence and prevalence data on ISH and evaluated several potential factors for its occurrence in the Framingham Heart Study during 16 biennial examinations. The factors evaluated were age, sex, all components of the blood pressure (systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure), Metropolitan relative weight, serum cholesterol level, serum uric acid level, cigarette smoking, ventricular heart rate, glucose intolerance, and hematocrit. The population at risk (1687 men and 1992 women) were those members of the Framingham cohort with a systolic blood pressure less than 160 mm Hg in the first four biennial examinations. Results showed ISH in 14.4% of the men and 22.8% of the women. Cumulative incidence rates were 418 per 1000 in men and 533 per 1000 in women. Significant risk factors for ISH were age, sex, all components of the blood pressure, and increased relative weight in women. We conclude that ISH is a highly prevalent disorder. Its major determinants are age, sex, increasing levels of blood pressure, and obesity in women.
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            A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response

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              Statement on hypertension in the elderly. The Working Group on Hypertension in the Elderly


                Author and article information

                S. Karger AG
                January 2000
                17 January 2000
                : 92
                : 1
                : 39-44
                Dipartimento Clinico di Medicina Interna, Geriatria, Patologia Cardiovascolare ed Immunitaria, Cardiochirurgia, Riabilitazione Cardiovascolare, Facoltà di Medicina, Università di Napoli Federico II, Naples, Italy
                6944 Cardiology 1999;92:39–44
                © 2000 S. Karger AG, Basel

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                Page count
                Figures: 1, Tables: 4, References: 36, Pages: 6
                Clinical Pharmacology


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