Cardiac effects of isradipine in patients with hypertension.

Isradipine is a dihydropyridine calcium antagonist used for the treatment of hypertension. It is highly selective for vascular smooth muscle, more than cardiac muscle, and thus, lowers systemic blood pressure by reducing peripheral vascular resistance. Isradipine has less negative exotropic effect than other available calcium antagonists, and generally does not affect cardiac output, stroke volume, or heart rate when used chronically to treat hypertension. This agent has been shown to reduce left ventricular mass in patients with left ventricular hypertrophy after 5 to 10 months of therapy, without affecting cardiac output. Unlike most other calcium antagonists, isradipine can be used safely in hypertensive patients with congestive heart failure because its use in blood pressure lowering dosages does not compromise pump function. Isradipine has antiischemic properties and, in animals, antiatherosclerotic properties. Generally, it is a safe, well-tolerated agent for the treatment of hypertension with primarily benign effects on the heart.