Ansquer JC Boussac I Lagrue G [Treatment of arterial hypertension. Efficacy of nitrendipine 20 mg/day] Traitement de l'hypertension arterielle. Efficacite de la nitrendipine 20 mg/j. [Additional information: ABSTRACT ONLINE, ADDRESS] In: Presse Med (1992 Apr 18) 21(15):703-7 The effectiveness and acceptability of nitrendipine, given as a single 20 mg tablet in the morning, were evaluated in general practice in 6.058 hypertensive patients. Visits were planned after 2, 6 and 12 weeks of treatment. Eighty-nine percent completed the 12- week study, 95 percent of them receiving 20 mg of nitrendipine once daily. Adverse events were observed in 26 percent of the patients, mainly during the first two weeks, when flushing and peripheral edema occurred in 9 and 7 percent of the patients respectively. Both led to withdrawal of 4 percent of the patients included over 3 months. A supine diastolic blood pressure below 90 mmHg was achieved in 65 percent of the patients, irrespective of age, sex, activity, smoking habits, and presence of diabetes or previous antihypertensive therapy. This large-scale study further established the effectiveness of nitrendipine as monotherapy given once daily in most hypertensive patients. Eight out of 10 patients felt they had benefited from the treatment. The investigators were satisfied with the results in 66 percent of the patients. They considered that the main advantage of nitrendipine was ease of use. Service de Nephrologie Hopital Henri Mondor Creteil. Graham SP Vetrovec GW Comparison of angiographic findings and demographic variables in patients with coronary artery disease presenting with acute pulmonary edema versus those presenting with chest pain. [Additional information: ABSTRACT ONLINE, ADDRESS] In: Am J Cardiol (1991 Dec 15) 68(17):1614-8 One hundred nineteen patients admitted to the coronary care unit with pulmonary edema were retrospectively reviewed to identify the demographic characteristics and underlying cardiac disorders of this population. The patients with pulmonary edema were compared with 119 patients admitted to the coronary care unit with chest pain. Cardiac catheterization in 71 patients with pulmonary edema and 93 with chest pain showed left main and 3-vessel coronary artery diseases to be equally common in both groups, although anginal pain was infrequent in patients with pulmonary edema (n = 28, 24%). Left ventricular function was reduced in the patients with pulmonary edema compared with those with chest pain (mean ejection fraction 42 vs 59%; p less than 0.001). More patients with pulmonary edema were black, and had diabetes and preexisting hypertension than those with chest pain. The results of cardiac catheterization were the same for black and white patients with pulmonary edema. In conclusion, patients with pulmonary edema have a high incidence of cardiac disease, and pulmonary edema may be 1 manifestation of silent myocardial ischemia. Important demographic differences exist between patients admitted with pulmonary edema and those who present with chest pain. Cardiology Division Medical College of Virginia Virginia Commonwealth University Richmond. Williams SA Rayman G Tooke JE Dependent oedema and attenuation of postural vasoconstriction associated with nifedipine therapy for hypertension in diabetic patients. [Additional information: ABSTRACT ONLINE, ADDRESS] In: Eur J Clin Pharmacol (1989) 37(4):333-5 We studied the incidence of oedema 2 weeks following initiation of nifedipine therapy for hypertension in a group of 10 diabetic subjects, and also measured skin blood flow (SBF) with a laser Doppler flowmeter, before and after lowering the foot. SBF with the foot horizontal increased after nifedipine from 0.31 V (arbitrary units of flow) to 0.51 V (NS). The postural fall in blood flow in dependency was significantly attenuated by nifedipine from 64.4 to 24.0%. Five patients developed ankle oedema. Results were similar in a small group of non-diabetic subjects starting nifedipine. The attenuation of reflex postural vasoconstriction is therefore likely to contribute to development of the oedema associated with starting nifedipine therapy, which should be monitored carefully in diabetic patients. Department of Physiology Charing Cross and Westminster Medical School London England.