Effects of sustained-release isradipine on left ventricular anatomy and function in systemic hypertension.

With use of digitized M-mode echocardiograms and 24-hour noninvasive ambulatory blood pressure (BP) monitoring, the effects of chronic treatment with sustained-release isradipine on left ventricular (LV) morphology and function in hypertensive patients were evaluated. We selected 12 patients with LV hypertrophy and normal LV diastolic diameter. Echocardiograms and 24-hour BP monitoring were performed after 2 weeks of placebo and after 6 months of oral treatment with sustained-release isradipine (5 mg once daily). Therapy significantly reduced BP without changes in heart rate. LV mass decreased in all patients and peak lengthening rate of LV diameter, index of diastolic function, increased in all, with normalization in 7 of the 9 with basal diastolic impairment. Peak shortening rate of LV diameter, index of systolic function, was normal in all patients at basal evaluation and did not change after therapy. Reduction in LV mass significantly (p < 0.05) correlated with the decrease in average 24-hour and daytime systolic and diastolic BP. Sustained-release isradipine administered once daily is an effective antihypertensive agent; the drug also induces regression of LV hypertrophy, with significant improvement in LV diastolic function and no deterioration in systolic function.