Nifedipine and Arotinolol in Combination for Accelerated-Malignant Hypertension: Results of One Year Follow-Up.

Abstract

The effects of a combined therapy with a calcium channel antagonist and a$-blocker in patients with accelerated-malignant hypertension on blood pressure and renal function were examined. Thirteen patients presented with the clinical features of malignant hypertension (diastolic blood pressure >130 mmHg, retinal damage and progressive renal failure) at our hospital, over the 3 yr period from 1995 to 1997. These patients were treated with both a calcium antagonist, 60-80 mg/d dose of long acting nifedipine, and an a/9-blocker, 20 mg/d dose of arotinolol, for over 12 mo. At admission, the average blood pressure of the patients was 233 ± 8/144 ± 3 mmHg. The level of serum creatinine in these patients was 6.2 ± 1.0 mg/dl. Intermittent hemodialysis therapy was introduced in 7 patients. Three days after treatment, blood pressure decreased to 162 ± 4/ 102 ± 4 mmHg. A month later, blood pressure decreased to 148 ± 3/89 ± 2 mmHg and serum creatinine levels were 3.6 ± 0.4 mg/dl. Renal function in these patients improved, and they completely recovered from renal dysfunction, allowing withdrawal of haemodialysis therapy. One year later, the blood pressure in all of these patients was well controlled and no further renal deterioration was observed, except in one patient. Despite the reduction in blood pressure, one patient was on hemodialysis three times a week after 8 mo of treatment. From these finding, it is concluded that combination therapy with a calcium antagonist and ai9-blocker is effective in both the reduction of highly elevated blood pressure and protection of the kidneys, resulting in amelioration of accelerated-malignant hypertension. (Hypertens Res 1999; 22: 75-'80)

Control of Blood Pressure and Prevention of End-Organ Damage in Patients with Accelerated Hypertension by Combination with Arotinolol and Extended Release Nifedipine.

“…In our previous study (33), we clearly demonstrated that combination therapy with arotinolol, an a/3 blocker, and nifedipine, an extended release calcium antagonist, is effective for both the reduction of highly elevated blood pressure and the protection of the kidney. In the present study, we extended this previous investigation to a followup of 3 years' duration, and added another important finding, i. e. , that this therapy improved LVH in patients with accelerated hypertension.…”

A rare case of malignant-phase hypertension with pulmonary alveolar hemorrhage

“…Most patients can be managed with oral antihypertensive therapy [3,4]. Combination therapy with arotinolol and extended-release nifedipine may be beneficial for the improvement of renal impairment and cardiac damage in patients with malignant-phase hypertension [5]. The blood pressure in our patient was successfully managed with a calcium antagonist and a b-blocker.…”