Document Detail


Effect of regular phosphodiesterase type 5 inhibition in hypertension.
MedLine Citation:
PMID:  16940217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are no published controlled clinical trials of regular phosphodiesterase type 5 inhibitor therapy as a long-term treatment of hypertension. In a randomized, double-blind, 2-way crossover study, 25 otherwise untreated hypertensive subjects were administered 50 mg of sildenafil or matched placebo 3 times daily for 16 days, and the effects on ambulatory blood pressure (BP), clinic BP, arterial wave reflection, carotid-femoral pulse wave velocity, and brachial artery flow-mediated dilatation were assessed. Three subjects were withdrawn because of adverse effects, and the data from the remaining 22 subjects were analyzed. Sildenafil reduced ambulatory BP (mean [SE] change from baseline for average daytime BP: systolic -8 [2] mm Hg versus 2 [2] mm Hg with placebo, P<0.01; diastolic -6 [1] mm Hg versus 0 [1] mm Hg, P<0.01) and clinic BP (change from baseline to 1 hour after drug administration on day 16: systolic -5 [2] mm Hg versus 4 [2] mm Hg, P<0.01; diastolic -5 [1] mm Hg versus 2 [2] mm Hg, P<0.01). Compared with baseline, sildenafil, but not placebo, reduced arterial wave reflection both acutely and after chronic treatment, but the chronic change in arterial wave reflection was not statistically different from the chronic change with placebo. Sildenafil did not affect pulse wave velocity or flow-mediated dilatation. The main adverse effects of sildenafil, which were generally transient and rated as mild or moderate in severity, were dyspepsia, headache, and myalgia. In conclusion, regular sildenafil constitutes effective antihypertensive therapy. Further studies are warranted to evaluate the role of longer-acting phosphodiesterase type 5 inhibitors as antihypertensive agents in clinical practice.
Authors:
James J Oliver; Vanessa P Melville; David J Webb
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2006-08-28
Journal Detail:
Title:  Hypertension     Volume:  48     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-22     Completed Date:  2006-10-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  622-7     Citation Subset:  IM    
Affiliation:
University of Edinburgh, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
3',5'-Cyclic-GMP Phosphodiesterases / administration & dosage,  adverse effects,  therapeutic use*
Blood Flow Velocity
Blood Pressure / drug effects
Blood Pressure Determination / methods
Blood Pressure Monitoring, Ambulatory
Brachial Artery / physiopathology
Carotid Arteries / physiopathology
Cross-Over Studies
Cyclic Nucleotide Phosphodiesterases, Type 5
Double-Blind Method
Drug Administration Schedule
Femoral Artery / physiopathology
Humans
Hypertension / drug therapy*,  physiopathology*
Office Visits
Phosphodiesterase Inhibitors / therapeutic use*
Piperazines / administration & dosage,  adverse effects,  therapeutic use*
Pulse
Purines
Regional Blood Flow
Sulfones
Vasodilation
Chemical
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Sulfones; 139755-83-2/sildenafil; EC 3.1.4.35/3',5'-Cyclic-GMP Phosphodiesterases; EC 3.1.4.35/Cyclic Nucleotide Phosphodiesterases, Type 5; EC 3.1.4.35/PDE5A protein, human
Comments/Corrections
Comment In:
Hypertension. 2006 Oct;48(4):546-8   [PMID:  16966577 ]
Curr Hypertens Rep. 2007 Apr;9(2):119-20   [PMID:  17442222 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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