Circadian rhythm of blood pressure and calcium entry blockade: a chronobiologic study with nitrendipine in essential hypertension.

In order to evaluate the chronobiologic effect of nitrendipine, 27 patients with mild-to-moderate arterial essential hypertension were studied. After randomized administration of 20 mg of nitrendipine and placebo, systolic and diastolic blood pressure (SBP and DBP, respectively) and heart rate (HR) were measured for 24 h using an automatic noninvasive device. The data of the time series were statistically analyzed by single and mean cosinor methods (obtaining mesor, amplitude, and acrophase) and by ANOVA and Student's paired t test. Nitrendipine significantly reduced the SBP and DBP mesors without affecting the HR mesor, and reduced the SBP and DBP amplitudes while increasing the HR amplitude. After placebo, group circadian rhythms were observed for SBP, DBP, and HR and maintained after nitrendipine. In conclusion, a single-dose administration of nitrendipine is effective in lowering blood pressure. The increased HR amplitude is probably due to a tachycardic reaction. The preservation of the SBP, DBP, and HR group circadian rhythms agrees with the lack of interference of the drug with the neurohormonal mechanisms.