Hypertension Clinical Trial
Official title:
Acute Effect of Nitroglycerin on Cyclosporine-Induced Hypertension After Cardiac Transplantation
The aim of the study was to evaluate the acute effect of nitroglycerine infusion on blood pressure and heart rate in heart-transplanted patients with cyclosporine-induced hypertension.
Background: Cyclosporine represents a milestone in immunosuppression after organ
transplantation. Its use, however, comes at the cost of significant side effects, such as
arterial hypertension. Our aim was to investigate the effect of acute administration of
nitroglycerin in heart-transplanted patients with cyclosporine-induced hypertension.
Methods: We included 18 hypertensive patients (HT) scheduled for elective cardiac
catheterization after heart transplantation and treated with cyclosporine, as well as
6-matched HT. Simultaneous measurements of BP in the aorta and pulmonary artery before and
after administration of nitroglycerin were done.
Results: After injection of 50μg and 100μg nitroglycerin a significant BP decrease was
observed both in heart-transplanted patients (sBP p=0.0001; dBP p=0.0001) and in controls
(sBP p=0.006; dBP p=0.05). This reduction was more pronounced in heart-transplanted patients
(sBP p=0.022; dBP 0.018 for group comparison). 8±3 minutes after the last nitrate infusion
BP remained significantly reduced vs baseline in heart-transplanted patients (p<0.001) while
it comes back to baseline in controls. The reduction in sBP (p=0.04 after 50μg
nitroglycerin; p=0.05 after 100μg nitroglycerin) but not dBP correlated to cyclosporinemia.
Conclusions: This study indicates that nitroglycerin reduces sBP in heart-transplanted
patients with cyclosporine-induced hypertension. Further studies are needed to evaluate the
long-term effect of nitrates in these patients.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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