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At least 19 recordsLinked to original sources
PubMed1997

Addition of felodipine to metoprolol vs replacement of metoprolol by felodipine in patients with angina pectoris despite adequate beta-blockade. Results of the Felodipine ER and Metoprolol CR in Angina (FEMINA) Study. Working Group on Cardiovascular Research, The Netherlands (WCN).

AIMS: The study aimed to compare the addition of felodipine to metoprolol, and of the replacement of metoprolol by felodipine, with continuation of metoprolol, in patients with angina pectoris despite optimal beta-blockade. METHODS AND RESULTS: The study was double-blind, parallel, randomized and controlled, and comprised 363 patients from 27 outpatient cardiology clinics in the Netherlands. The patients had angina and positive bicycle exercise tests despite optimal beta-blockade (resting heart rate < 65 beats.min-1). Randomization was to three treatment groups: continuation of metoprolol (control), addition of felodipine to metoprolol, and replacement of metoprolol by felodipine. Exercise tests were repeated after 2 and 5 weeks. The main outcome measure was: exercise result after 5 weeks, compared with baseline, between-group comparison of changes vs control. There were no significant differences in exercise duration and onset of chest pain vs control. The addition of felodipine increased time until 1 mm ST depression (43 s, 95% confidence interval 20-65 s), and decreased both ST depression at highest comparable work load (0.46 mm, 95% confidence interval 0.19-0.72), and maximal ST depression (0.49 mm, 95% confidence interval 0.23-0.74). Exercise results after replacement of metoprolol by felodipine were not different from control, apart from a significant increase in rate pressure product. Significantly more patients experienced adverse events in the felodipine monotherapy group. CONCLUSION: Combination of metoprolol and felodipine is to be preferred to felodipine monotherapy in patients who have signs and symptoms of myocardial ischaemia despite optimal beta-blockade.

Adolescent↗
PubMedDate not supplied

Long-term efficacy, tolerability, and safety of the combination of enalapril and felodipine ER in the treatment of hypertension. Enalapril-Felodipine ER Factorial Study Group.

A recent 8-week, double-masked, placebo-controlled, 3 x 4 factorial-design study demonstrated that enalapril-felodipine extended-release (ER) combinations had statistically significant additive effects for reducing both sitting systolic blood pressure (SiSBP) and sitting diastolic blood pressure (SiDBP) and were generally well tolerated in hypertensive patients with SiDBPs ranging from 95 to 115 mm Hg. The present open-label study was undertaken to assess the long-term efficacy, tolerability, and safety of such combinations. Patients from the factorial study were eligible for the 1-year, open-label extension. Initially, all patients received enalapril 5 mg-felodipine ER 2.5 mg once daily; if SiDBP was not controlled (< 90 mm Hg) after 4 weeks of treatment, the dose was titrated upward at 2- to 4-week intervals to a maximum of enalapril 10 mg-felodipine ER 10 mg. Hydrochlorothiazide (HCTZ) 12.5 mg was added to the regimen of patients whose hypertension was not controlled at the highest enalapril-felodipine ER dose. A total of 507 patients were enrolled, of whom 502 were assessable. At their last study visit, 391 (78%) of the assessable patients were receiving only an enalapril-felodipine ER combination. The enalapril-felodipine ER combinations resulted in mean trough SiDBPs of 85 to 89 mm Hg (decreases of 13 to 16 mm Hg from baseline) and SiSBPs of 137 to 140 mm Hg (decreases of 13 to 21 mm Hg). Overall, 407 (81%) of the 502 assessable patients achieved an SiDBP < 90 mm Hg or a reduction from baseline > or = 10 mm Hg (responders); such a response was recorded in 331 patients (66%) taking a combination of enalapril-felodipine ER alone and 76 patients (15%) taking the combination with the addition of HCTZ 12.5 mg. Blood pressure reductions were maintained throughout the treatment period. Drug-related adverse events were relatively infrequent, often transient, usually mild, and apparently not dose related. The most frequently reported drug-related adverse events were edema/swelling, asthenia/fatigue, dizziness, cough, and headache. These results suggest that combination therapy with enalapril-felodipine ER is effective for long-term blood pressure reduction, has an excellent safety profile, and is generally well tolerated. Addition of low-dose HCTZ to the enalapril-felodipine ER combination appears to provide further blood pressure control without increasing drug-related adverse events.

Adult↗
PubMed1988

Antihypertensive efficacy of the calcium-antagonist felodipine in patients with persisting hypertension on beta-adrenoceptor blocker therapy. The Canadian Felodipine Study Group.

1. The antihypertensive efficacy of two different doses of the calcium antagonist felodipine was evaluated in patients with hypertension persisting despite beta-adrenoceptor blocker therapy. Following a single-blind placebo period of 4 weeks, patients were randomized to placebo (n = 36), felodipine 5 mg twice daily (n = 39) and felodipine 10 mg twice daily (n = 35) for another 4 weeks. beta-adrenoceptor blocker therapy remained unchanged throughout the study. 2. Effects on blood pressure (BP) were evaluated after the first dose and after chronic dosing at 2 h after dosing and the end of the dosing interval (12 h). 3. Felodipine decreased systolic and diastolic BP by 30-35/20-25 mm Hg at 2 h. These decreases were similar after acute and chronic treatment. Twelve hours after dosing, decreases of 15-20/10-15 mm Hg were observed compared to 10/5 mm Hg on placebo, and half of the patients still had a controlled BP (supine diastolic BP less than 90 mm Hg). BP responses were rather similar for both doses of felodipine at 2 and 12 h. 4. Multiple regression analysis showed that both initial BP level and plasma felodipine concentrations were significant predictors of the BP response to felodipine, but age was not. 5. Adverse effects attributed to felodipine were mainly related to vascular symptoms (primarily flushing and ankle swelling); these occurred in about 30% of patients, and were pronounced in three patients (4%). 6. Felodipine is therefore highly effective in lowering BP of hypertensive patients on chronic beta-adrenoceptor blocker therapy, with no evidence for a gradual lowering of the BP or for development of tolerance. Both initial BP level and plasma concentrations are better indicators of antihypertensive efficacy of this calcium antagonist than age.

Adrenergic beta-Antagonists↗
PubMed1997

Blood pressure reduction and tolerability of felodipine ER in older and younger hypertensive patients. The Felodipine ER in the Elderly versus Young Working Group.

OBJECTIVE: To evaluate and compare blood pressure reduction and tolerability of felodipine ER (extended-release), in younger and older patients. DESIGN: A multicenter, double-blind, placebo-controlled, parallel group study. SETTING: Nineteen study sites; approximately half of the sites were at academic medical centers and half were in private primary care practices. Patients were non-hospitalized and free-living. PATIENTS: There were 243 younger (< or = 61 years) and older (> or = 64 years) patients, age range 26 to 83, with sitting diastolic blood pressure (SDBP) of 95-115 mm Hg (higher stage 1 to lower stage 3) on placebo. Patients volunteered for the study. INTERVENTIONS: After a 2 to 4 week, single-blind, placebo baseline period, patients with SDBP of 95-115 mm Hg were randomized to treatment with felodipine ER 2.5 mg qd or placebo at a ratio of 3:1, felodipine:placebo. The dose of felodipine ER was increased to 5 mg qd after 3 weeks and to 10 mg qd after 6 weeks if the SDBP was greater than 90 mm Hg. MEASUREMENTS: The main outcome measure was change in SDBP. Secondary Outcome measures were change in sitting systolic blood pressure (SSBP) and percent of responders, defined as SDBP less than 90 mm Hg or a > or = 10 mm Hg reduction. Other measurements included heart rate, weight, routine laboratory values, and self-reported adverse events. RESULTS: By Week 9, felodipine ER reduced blood pressure in the older subjects (n = 77) by 13/12 mm Hg; in the younger patients, (n = 102), the reduction was 12/8 mm Hg. All reductions were significantly different from placebo (P < or = .003). The reduction in diastolic, but not systolic, blood pressure was significantly greater in the older than in the younger patients (P = .004 and P = .188, respectively). The percentage of patients reporting a clinical adverse experience was similar for felodipine ER and placebo treatment groups. The incidence of side effects was similar between old and young patients. Discontinuation occurred in 9% of the felodipine-treated patients and 19% of the placebo-treated patients. Older patients required lower doses of felodipine ER to achieve equivalent blood pressure control. CONCLUSIONS: Felodipine ER is effective in lowering blood pressure and is well tolerated in both young and old people.

Adult↗
PubMed1993

Antihypertensive effect and tolerability of felodipine extended release (ER) tablets in comparison with felodipine plain tablets (PT) and placebo in hypertensives on a diuretic. Canadian Study Group.

Antihypertensive efficacy and tolerability of felodipine extended release (ER) (o.d.), felodipine plain tablet (PT) (b.i.d.), and placebo were compared in mild to moderate hypertensives whose seated diastolic blood pressure (DBP) was > or = 95 mm Hg while on hydrochlorothiazide 25 mg od. In addition to the diuretic, patients were randomised to felodipine ER 5 mg od (n = 50), PT 2.5 mg bid (n = 50), or placebo (n = 48) for 6 weeks, with clinic visits every 2 weeks. If seated DBP was > or = 90 mm Hg at any visit, daily dosage of felodipine was doubled to a maximum of 20 mg. The mean difference between ER and placebo was 5.1 mm Hg (p = 0.003); for PT vs. placebo the difference was 5.3 mm Hg (p = 0.002). Seated systolic blood pressure (SBP) was reduced by a mean difference of 6.8 mm Hg in the felodipine PT group compared with placebo (p = 0.03). Fourteen patients were withdrawn: 4 from the placebo group, 4 from the felodipine ER group, and 6 from the felodipine PT group. The most commonly reported adverse event was peripheral edema. In patients not adequately controlled on diuretic alone, felodipine ER o.d. and felodipine PT b.i.d. were superior to placebo in reducing seated DBP.

Adult↗
PubMed1997

Combined enalapril and felodipine extended release (ER) for systemic hypertension. Enalapril-Felodipine ER Factorial Study Group.

This multicenter, placebo-controlled, double-blind trial of factorial design evaluated the safety and efficacy of combination treatment with the angiotensin-converting enzyme inhibitor, enalapril, and the vascular selective calcium antagonist felodipine extended release (ER) in patients with essential hypertension. After a 4-week, single-blind placebo baseline period, 707 patients with sitting diastolic blood pressures (BPs) in the range of 95 to 115 mm Hg received placebo, enalapril (5 or 20 mg), felodipine ER (2.5, 5, or 10 mg), or their combinations for an 8-week double-blind treatment period. All doses of enalapril and felodipine ER had a statistically significant (p < 0.05) additive effect in reducing both systolic and diastolic BP. The trough to peak ratios for the combinations ranged from 0.63 (enalapril 5 mg-felodipine ER 2.5 mg) to 0.79 (enalapril 20 mg-felodipine ER 10 mg) and were consistent with effective BP control with 1 dose/day. Patients aged > or = 65 years demonstrated a greater reduction in diastolic BP. Combinations of enalapril-felodipine ER were associated with less drug-induced peripheral edema (4.1%) compared to felodipine ER monotherapy (10.8%). There were no serious drug-related adverse effects observed during the study. In this trial, the combination of enalapril and felodipine ER effectively lowered BP and was generally well tolerated with an excellent safety profile when used in the treatment of hypertension.

Aged↗
PubMed1990

Optimal felodipine dose when combined with metoprolol in arterial hypertension: a Swedish multicenter study within primary health care. Swedish General Practitioner Felodipine Study Group.

In a multicenter study comprising 23 Swedish primary health care centers, felodipine extended-release (ER) tablets in doses of 5, 10, and 20 mg were compared double-blind with placebo when given in addition to metoprolol controlled-release (CR) tablets 100 mg. All medication was given once daily in the morning. Altogether, 251 hypertensive patients with a diastolic blood pressure greater than 95 mm Hg after 4 weeks of treatment with placebo in combination with metoprolol CR 100 mg were randomized to four parallel groups. After 4 weeks of treatment, there were significantly greater reductions in blood pressure with all doses of felodipine ER than with placebo, both 2 and 24 h after intake of the tablets. Twelve patients were withdrawn because of adverse reactions. Of these, one patient was taking placebo, one 5 mg of felodipine ER, four 10 mg of felodipine ER, and six patients 20 mg of felodipine ER. When combined with metoprolol, 5 mg of felodipine ER seemed to be less effective than higher doses, but was very well tolerated. Adding 10 mg of felodipine ER to the basal metoprolol appeared to be optimal if both the effect and adverse reactions were taken into consideration.

Adult↗
PubMed1994

Felodipine therapy may not alter glucose and lipid metabolism in hypertensives. Felodipine Multicenter Prospective Study Group in Japan.

The effects of long-term monotherapy with felodipine, a calcium antagonist, on blood pressure, glucose tolerance, and serum lipid profiles were prospectively investigated in 51 hypertensive patients: 13 with normal glucose tolerance and 38 with glucose intolerance. The levels of plasma glucose, serum lipids, and glycosylated hemoglobin A1c were determined before and during long-term (7.5 +/- 0.5 months; range, 6 to 9 months) therapy with felodipine. A 75-g oral glucose tolerance test was performed before and during long-term felodipine therapy. Significant decreases in both systolic and diastolic blood pressures in both patient groups were maintained during the therapy. Neither fasting nor post-glucose load venous plasma glucose levels were altered in either group of patients, and no patients with normal glucose tolerance developed diabetes mellitus during the study. Serum lipid levels did not change significantly in either group of patients except for significant decreases in high-density lipoprotein cholesterol and apolipoprotein A-I in the group with normal glucose tolerance tests, but those changes remained within the normal range. Furthermore, neither serum lipid nor apolipoprotein levels were altered, even in patients with hypercholesterolemia (total cholesterol levels, > 5.69 mmol/L = 220 mg/dL). These results suggest that long-term therapy with felodipine may not alter glucose and lipid metabolism in hypertensive patients, and felodipine appears to be useful as an antihypertensive agent for hypertensive patients with either dyslipidemia or impaired glucose metabolism.

Analysis of Variance↗
PubMed1991

Felodipine in combination with a beta-adrenoceptor blocker as an effective substitute for triple therapy in severe hypertension. The Australian Felodipine Multicentre Study Group.

We have studied the efficacy and tolerability of felodipine plus a beta-adrenoceptor blocker in 79 patients with essential hypertension previously treated with a combination of three or more anti-hypertensive agents, one of which was a beta-adrenoceptor blocker. After a 4-week run-in period on the same beta-blocker plus placebo (as a substitute for the other agents in the regimen), felodipine was added and its dose titrated to achieve a supine diastolic blood pressure or less than 90 mm Hg. This was followed by a 12-week maintenance phase in all patients, and 47 patients entered an optional long-term follow-up for an additional 9 months. The mean supine blood pressure was 149/88 mm Hg at entry and 174/108 mm Hg after the run-in phase. Felodipine significantly reduced the blood pressure to 142/85 mm Hg after dose titration and to 141/84 mm Hg after 12 weeks, 94% of patients achieving a supine diastolic blood pressure of 90 mm Hg or below. This reduction was maintained in the patients who were followed for 12 months. The adverse events recorded were usually mild, transient, and typical for an effective precapillary vasodilator. Nine of 74 patients (11%) were withdrawn in the first phase of the study because of adverse events and 5 of 47 patients were withdrawn during the long-term follow-up. These results show that the efficacy and tolerability of a combination of felodipine with a beta-blocker allow a simplified regimen for hypertensive patients who were previously taking three or more drugs for satisfactory blood pressure control.

Adolescent↗
PubMed1990

Biliary secretion of felodipine metabolites in man after intravenous [14C]felodipine.

The biliary secretion of [14C]felodipine in 4 healthy human subjects was studied by use of the multiple marker dilution principle with double lumen tubes placed in the stomach and intestine. Insignificant amounts of 14C activity were recovered from gastric aspirates. The individual recovery from intestinal aspirates varied from 2.9 to 8.5% of the dose of radioactivity over the period of 4.5 h after dosing. Less than 0.1% was identified as unchanged felodipine. The results show that biliary secretion is a minor route of elimination of felodipine or its metabolites. Bile collection for 4.5 h had no significant effect on the pharmacokinetics of felodipine, although the 72 h urinary recovery of radioactivity tended to be lower when bile was collected (59%) than in the control experiment (66%).

Adult↗
PubMed1994

Extended-release felodipine in patients with mild to moderate hypertension. Felodipine ER Dose-Response Study Group.

Two hundred eighty-six patients with mild to moderate hypertension who had untreated diastolic blood pressure while seated of 95 to 115 mm Hg were randomized to receive placebo or once-daily doses of 2.5, 5, or 10 mg of the dihydropyridine calcium channel blocker felodipine extended release (ER). Blood pressure was measured 24 hours after dosing (at trough). Mean reductions in diastolic blood pressure after 8 weeks of double-blind treatment were significantly greater in each of the ER felodipine treatment groups (2.5, 5, and 10 mg ER felodipine: -7.8, -9.5, and -11.3 mm Hg, respectively) than in the placebo group (-5.3 mm Hg). The effect was dose dependent for both diastolic and systolic blood pressure. Moreover, much of the peak antihypertensive effect was still present at trough, confirming the 24-hour efficacy of the drug. Felodipine was well tolerated.

Administration, Oral↗
PubMed1992

Regression of left ventricular hypertrophy during long-term antihypertensive treatment--a comparison between felodipine and the combination of felodipine and metoprolol.

Seventy-six hypertensive patients with left ventricular hypertrophy (LVH) were randomized to receive felodipine or felodipine plus metoprolol in a double-blind parallel-group study. The doses of each treatment regimen were titrated to obtain a diastolic blood pressure (BP) of less than 95 mmHg. The duration of the treatment was 9 months. At the end of the study, BP was significantly reduced in both groups, and the reduction did not differ between the groups. Left ventricular posterior wall and septum thickness were significantly and similarly reduced in both groups. Left ventricular systolic and diastolic end diameters were not significantly changed. Left ventricular mass (LVM) was significantly and similarly reduced in both treatment groups, as was the ratio of LVM and left ventricular end diastolic volume. In conclusion, felodipine and the combination of felodipine and metoprolol reduced left ventricular hypertrophy to the same extent when BP was similarly reduced.

Adult↗
PubMed1987

Felodipine, a new calcium antagonist, as monotherapy in mild or moderate hypertension. Cooperative study group.

The role of felodipine, a new calcium antagonist, as monotherapy in mild and moderate hypertension (supine diastolic blood pressure between 95 and 100mm Hg: phase V) was investigated in a placebo-controlled, double-blind study of 109 patients from 13 centres using 3 different doses. After a 2-week placebo run-in phase the patients were randomised in a double-blind fashion to receive felodipine 2.5mg bid (32 patients), 5 mg bid (30 patients), 10mg bid (24 patients) or placebo (25 patients). Clinical and laboratory measurements were performed after 1, 3 and 8 weeks. 94 patients completed the study. Felodipine reduced supine systolic blood pressure by 22mm Hg from baseline after 8 weeks' treatment on 2.5mg bid, 24mm Hg on 5mg bid and 24mm Hg on 10mg bid at 2 hours after dosage. The corresponding reduction in the placebo group was 6mm Hg. There was a reduction in supine diastolic blood pressure from baseline of 13mm Hg on felodipine 2.5mg bid, 14mm Hg on felodipine 5mg bid and 20mm Hg on felodipine 10mg bid, with no reduction in patients receiving placebo. The percentage of patients completing the study who achieved a supine diastolic blood pressure of 90mm Hg or less after 8 weeks' treatment at 2 hours after dosage was 9% on placebo, 67% on felodipine 2.5mg bid, 57% on felodipine 5mg bid and 92% on felodipine 10mg bid; and at 12 hours after dosage those achieving target supine diastolic blood pressure was 17% on placebo, 37% on felodipine 2.5mg bid, 25% on felodipine 5mg bid and 62% on felodipine 10mg bid. Felodipine was generally well tolerated, although 10 patients on felodipine 10mg bid (42%), 1 on felodipine 5mg bid (3%) and 2 on felodipine 2.5mg bid (6%) withdrew from the study because of adverse effects. One serious adverse event, a myocardial infarction, occurred during the study in a patient with a history of postprandial non-exertional chest pain. In conclusion, felodipine monotherapy appreciably reduces blood pressure in mild and moderate hypertension without significant tachycardia in the short term. Doses of felodipine 2.5mg bid and 5mg bid are better tolerated than 10mg bid and can be recommended for initial treatment in this category of patients.

Adult↗
PubMed1992

Felodipine pharmacokinetics and plasma concentration vs effect relationships.

UNLABELLED: Felodipine was completely absorbed from an oral solution (OS), as well as from the conventional (CT) and extended release (ER) tablets. The time to peak plasma concentration increased in the order OS < CT < ER. Peak plasma felodipine concentrations were significantly lower and trough concentrations higher when felodipine was administered in the ER-tablet compared with CT and oral solution. The variability in plasma felodipine concentration during the dose interval, expressed as the fluctuation index, increased in the order ER o.d. < CT b.i.d. < CT o.d. The distribution of the AUC of plasma felodipine concentrations vs time determined in 140 individuals was unimodal, indicating that genetic factors are unlikely to influence the metabolism of felodipine to any clinically significant extent. With increasing age the plasma concentrations and the terminal half-life of felodipine increased, whereas the plasma clearance and the ratio of the AUC of the primary pyridine metabolite to that of unchanged drug decreased. The time to maximum plasma felodipine concentration, the bioavailability and the volume of distribution were not consistently influenced by age. Body weight, body mass index and concomitant intake of beta-blockers had negligible influence on the pharmacokinetics of felodipine. The pharmacokinetics in the limited number females did not differ substantially from that of the males in our investigation. No consistent effect on blood pressure was seen in healthy subjects after administration of felodipine. In hypertensive patients, however, there was a good relationship between plasma felodipine concentration and antihypertensive effect. There was no hysteresis for the reduction in blood pressure. The relationship between plasma felodipine concentration and antihypertensive effect could, in most patients, be described by a modified Emax model. The average Emax value was estimated to be approximately 30 mmHg. Placebo correction decreased the magnitude of the blood pressure reduction. The Emax estimates increased with increasing initial blood pressures whereas age had a negligible effect. Patients with high and low plasma felodipine concentrations had similar Emax values. The EC50 values were not influenced by any of these factors. The Emax model used was less suitable for patients with low initial blood pressure levels. IN CONCLUSION: The plasma concentration vs time profile of felodipine is modified by using different pharmaceutical formulations, without loss of bioavailability. As a group, the elderly have higher total concentrations of unchanged felodipine in plasma compared with young individuals. The variation in plasma concentrations between individuals is, however, only partially explained by age. There is a good and direct relationship between felodipine plasma concentrations and antihypertensive effects in hypertensive patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗
PubMed1996

Pharmacokinetic interaction between cyclosporine and the dihydropyridine calcium antagonist felodipine.

OBJECTIVE: In a double blind, randomised, placebo-controlled, cross-over study 12 healthy male volunteers were allocated to receive felodipine + placebo, cyclosporine + placebo, and felodipine + cyclosporine in order to investigate the interaction between the calcium channel blocker felodipine and cyclosporine as it affects the pharmacokinetics of felodipine, dehydrofelodipine, and cyclosporine, and 24-hour blood pressure measurements. METHODS: Single doses of cyclosporine (capsules, 5 mg/kg body weight) and of felodipine (extended release (ER) tablets 10 mg) were given at a 1-2 week interval. Plasma drug concentrations were followed for 2 days after drug intake. RESULTS: For cyclosporine, Cmax was increased after combined treatment (16%) compared to cyclosporine alone, but felodipine did not influence other kinetic parameters of cyclosporine. For felodipine, combined treatment with cyclosporine and felodipine increased AUC and Cmax (58% and 151%, respectively) and lowered mean residence time (24%) significantly compared to felodipine alone. For the metabolite dehydrofelodipine, too, AUC and Cmax were increased after the combined treatment (43% and 94%, respectively). Mean 24-hour systolic and diastolic blood pressures were significantly lower after felodipine, both when felodipine was given alone (121/68 mmHg) and in combination with cyclosporine (122/68 mmHg) compared to cyclosporine alone (127/73 mmHg). CONCLUSION: A combined single dose of cyclosporine and felodipine in healthy subjects increased the AUC and Cmax of felodipine suggesting a cyclosporine-induced decrease in the first-pass metabolism of felodipine, whereas the AUC of cyclosporine was only slightly increased by felodipine.

Adult↗
PubMed1998

Haemodynamic and renal effects of felodipine in young and elderly subjects.

OBJECTIVE: To study the influence of age on renal and haemodynamic effects of the calcium antagonist felodipine. METHODS: Eight young (mean age 27 years) and eight elderly (mean age 75 years) healthy normotensive subjects were given felodipine intravenously for 120 min aiming at close to therapeutic plasma level concentration. Renal blood flow (RBF) and renal vascular resistance (RVR) was estimated from para-aminohippuric acid (PAH) clearance 51CrEDTA clearance was used to measure glomerular filtration rate (GFR) and used in the calculations of fractional excretion (FE) of electrolytes. Impedance cardiography was performed to assess stroke volume and for the calculation of cardiac output and ejection fraction. RESULTS: At the end of felodipine infusion, the concentration of felodipine was on average 10.0 nmol x l(-1) in young and 12.0 nmol x l(-1) in elderly subjects (NS). During felodipine infusion blood pressure (BP) decreased from 138/76 to 120/68 in elderly subjects. The BP in young subjects was 126/74 at basal and 125/70 after infusion of felodipine. The systemic and renal vascular resistance decreased to a similar extent in young and elderly subjects after felodipine infusion. Felodipine caused a decrease in systemic vascular resistance from 25.6 to 23.3 in elderly and from 23.8 to 21.8 in the young subjects. Mean values for RVR at baseline and during infusion of felodipine were significantly higher in the elderly (10.1-15.1) than in the young subjects (5.4-6.7). Felodipine reduced RVR by 10% in the young and by 12% in the elderly at the end of infusion. The young subjects had 31% higher GFR than the elderly subjects at the start of infusion. Felodipine infusion did not affect GFR. There were no effects on stroke volume and ejection fraction. An initial natriuretic effect was found after infusion of felodipine in the young subjects. The fractional excretion of all electrolytes tended to increase after both felodipine and placebo, more in the elderly than in the young subjects. CONCLUSION: The effects of felodipine on central and renal haemodynamics previously observed in young and middle-aged subjects also seem to exist in the elderly. Volume expansion seems to increase the excretion of electrolytes more in elderly than in young people, and therefore the effect of felodipine on natriuresis is more evident in young subjects.

Adult↗