Antihypertensive effect of isradipine on ambulatory and casual blood pressure.

The antihypertensive effect of isradipine was studied in 35 mild-to-moderate hypertensive patients (mean age 57 years) using casual and ambulatory 24-h blood pressure measurement. After the placebo phase, oral treatment was started with 1.25 mg isradipine twice daily for 4 weeks, which was increased to 2.5 mg twice daily if blood pressure was not normalized [in one patient, the new angiotensin-converting enzyme (ACE) inhibitor spirapril was added at a dose of 3 mg daily after 4 weeks]. The active-treatment period lasted 24 weeks. At the end of therapy, casual blood pressure decreased significantly (P < .001) from 174/103 to 151/86 mm Hg, and mean ambulatory blood pressure from 145/88 to 139/84 mm Hg (P < .05). The total number of hypertensive systolic and diastolic blood pressure values also decreased. When patients were divided into normotensives and hypertensives according to their initial ambulatory blood pressure, no effect of treatment was detected in the normotensive group. Casual blood pressure was higher than the 24-h ambulatory pressure.