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Nifedipine in Severely Hypertensive Patients With Congestive Heart Failure and Preserved Ventricular Systolic Function

Bruce D. Given, MD; Thomas H. Lee, MD; Peter H. Stone, MD; Victor J. Dzau, MD
Arch Intern Med. 1985;145(2):281-285. doi:10.1001/archinte.1985.00360020109018.
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• Nifedipine was used successfully in nine patients with refractory hypertension and left ventricular hypertrophy who had symptoms of congestive heart failure despite preserved left ventricular systolic function. The administration of 10 or 20 mg of nifedipine resulted in an acute decline in BP, from 211±8/105±6 mm Hg to 153±9/78±5 mm Hg. Six patients received nifedipine and one patient received long-term verapamil therapy (mean follow-up, 16±4 weeks). In addition to sustained BP control, signs and symptoms of congestive heart failure were greatly Improved in all patients treated long term with calcium channel antagonists. No adverse reactions were reported, but a short duration of action limited their usefulness in some patients. Nifedipine seems to be particularly beneficial in this subgroup of severe hypertensive patients with heart failure presumably due to diastolic stiffness of the left ventricle.

(Arch Intern Med 1985;145:281-285)

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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