- Calcium-Channel Blocking Agents, Dihydropyridine
- Calcium Antagonists
VA Class: CV200
Chemical Name: Methyl 2-methylpropyl ester 1,4-dihydro-2,6-dimethyl-4-(2-nitrophenyl)-3,5-pyridinedicarboxylic acid
Molecular Formula: C20H24N2O6
CAS Number: 63675-72-9
Medically reviewed on Jan 7, 2019
Uses for Nisoldipine
Calcium-channel blockers are recommended as one of several preferred agents for the initial management of hypertension; other options include ACE inhibitors, angiotensin II receptor antagonists, and thiazide diuretics.501 502 503 504 While there may be individual differences with respect to specific outcomes, these antihypertensive drug classes all produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.501 502 503 504 Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).500 501 502 503 504 515
Calcium-channel blockers may be preferred in hypertensive patients with certain coexisting conditions (e.g., ischemic heart disease)45 523 and in geriatric patients, including those with isolated systolic hypertension.502 510
Black hypertensive patients generally respond better to monotherapy with calcium-channel blockers or thiazide diuretics than to other antihypertensive drug classes (e.g., ACE inhibitors, angiotensin II receptor antagonists).500 501 504 However, diminished response to these other drug classes is largely eliminated when administered concomitantly with a calcium-channel blocker or thiazide diuretic.500 504
The optimum BP threshold for initiating antihypertensive drug therapy is controversial.501 504 505 506 507 508 515 523 530 Further study needed to determine optimum BP thresholds/goals; individualize treatment decisions.501 503 507 515 526 530
JNC 7 recommends initiation of drug therapy in all patients with uncomplicated hypertension and BP ≥140/90 mm Hg;500 JNC 8 panel recommends SBP threshold of 150 mm Hg for patients ≥60 years of age.501 Although many experts agree that SBP goal of <150 mm Hg may be appropriate for patients ≥80 years of age,502 504 505 530 application of this goal to those ≥60 years of age is controversial, especially for those at higher cardiovascular risk.501 502 505 506 508 511 515
In the past, initial antihypertensive drug therapy was recommended for patients with diabetes mellitus or chronic kidney disease who had BP ≥130/80 mm Hg;500 503 current hypertension management guidelines generally recommend a BP threshold of 140/90 mm Hg for these individuals (same as for the general population of patients without these conditions), although a goal of <130/80 mm Hg may still be considered.501 502 503 504 520 530 535 536 541
Nisoldipine Dosage and Administration
BP Monitoring and Treatment Goals
When available, use evidence-based dosing information (i.e., dosages shown in randomized controlled trials to reduce complications of hypertension) to determine target dosages; target dosages usually can be achieved within 2–4 weeks but may take up to several months.501
If adequate BP response not achieved with a single antihypertensive agent, add a second drug with demonstrated benefit; if goal BP still not achieved with optimal dosages of 2 antihypertensive agents, add a third drug.501 May maximize dosage of the first drug before adding a second drug, or add a second drug before maximizing dosage of the initial drug.501
Goal is to achieve and maintain optimal control of BP; individualize specific target BP based on consideration of multiple factors, including patient age and comorbidities, and currently available evidence from clinical studies.500 501 (See Hypertension under Uses.)
Extended-release tablets should be swallowed intact and should not be chewed, broken, or crushed.600
Reformulated extended-release tablets containing 8.5 or 34 mg of nisoldipine are bioequivalent to original extended-release formulation (no longer commercially available) containing 10 or 40 mg, respectively.84
Manufacturer recommends initial dosage of 17 mg once daily.600
Increase as tolerated in increments of 8.5 mg daily at weekly or less frequent intervals up to 34 mg once daily.600 Monitor BP carefully during initial titration or subsequent upward adjustment in dosage.600
Manufacturer states usual maintenance dosage is 17–34 mg once daily.600
If intolerable adverse effects occur, consider dosage reduction; if adverse effects worsen or fail to resolve, may need to discontinue and switch to another antihypertensive drug class.501
Maximum 34 mg daily.600
Initially, 8.5 mg daily; monitor BP response closely with each dosage adjustment.600
Reduce initial and maintenance dosages in patients with cirrhosis.1
Dosage modification not necessary in patients with mild to moderate renal impairment.1
Initially, 8.5 mg daily; monitor BP response closely with each dosage adjustment.600
Cautions for Nisoldipine
Known hypersensitivity to nisoldipine or other dihydropyridine-derivative calcium channel blockers.1
Increased Angina and/or Acute MI
Rarely, increased frequency, duration, and/or severity of angina or acute MI, particularly in patients with severe obstructive CAD, upon initiation or dosage increase of calcium-channel blockers.1
Some preparations may contain tartrazine (FD&C yellow No. 5), which may cause allergic reactions including bronchial asthma in susceptible individuals.600 Incidence of tartrazine sensitivity is low, but it frequently occurs in patients who are sensitive to aspirin.600
Risk of excessive, poorly tolerated hypotension; usually occurs during initial dosage titration or subsequent upward titration.1 Carefully monitor BP, especially during therapy initiation, titration, or dosage increase; closely observe patients currently receiving drugs known to lower BP.1
Use with caution in patients with heart failure or compromised ventricular function, especially in those receiving concomitant β-adrenergic blocking agents.1
Safety and efficacy not established.1
Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.1 Select dosage with caution.1 (See Geriatric Patients under Dosage and Administration.)
Common Adverse Effects
Peripheral edema, headache, dizziness, pharyngitis, vasodilation, sinusitis, palpitation, chest pain, nausea, rash.1
Interactions for Nisoldipine
Drugs Affecting Hepatic Microsomal Enzymes
Specific Drugs and Foods
Drug or Food
β-Adrenergic blocking agents
Increased risk of hypotension and exacerbation of heart failure1
Pharmacokinetic interaction unlikely1
Increased nisoldipine bioavailability1
Histamine H2-receptor antagonists
Possible increased nisoldipine concentrations with cimetidine; no significant interaction with ranitidine1
Decreased plasma concentrations of nisoldipine to undetectable levels1
Avoid concomitant use1
Possible decreased AUC of nisoldipine1
Clinical significance unknown1
Pharmacokinetic interaction unlikely1
Absolute bioavailability is low (about 5%), due to presystemic metabolism in the intestine; presystemic metabolism decreases from proximal to distal parts of intestine.1 600 601 602 Bioavailability of extended-release preparation is increased since nisoldipine is released in the colon where presystemic metabolism is reduced.1 601 602
A high-fat meal increases peak plasma concentrations by up to 245%, but decreases AUC by 25%.600
In geriatric patients, plasma concentrations increased about 2- to 3-fold.1
In patients with hepatic cirrhosis, plasma concentrations increased by 4–5 times.1
Not known whether nisoldipine is distributed into milk.1
Plasma Protein Binding
Extensively metabolized; major pathway appears to involve hydroxylation.600 Thought to be metabolized principally by CYP isoenzymes.1 Precise enzymes responsible for metabolism are unknown, but other dihydropyridine-derivative calcium-channel blocking agents are metabolized by CYP3A4.1
Excreted principally in urine (60–80%) as metabolites.1
Approximately 13.7 hours.600
Inhibits transmembrane influx of extracellular calcium ions across the membranes of myocardial cells and vascular smooth muscle cells.1
Peripheral arterial vasodilator; acts directly on vascular smooth muscle causing reduction in peripheral vascular resistance (afterload) and BP.1
Advice to Patients
Importance of swallowing extended-release tablets whole; do not chew, crush, or break.1
Importance of avoiding administration with a high-fat meal; administer 1 hour before or 2 hours after a meal.600
Importance of informing patients that some preparations may contain tartrazine.600
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses.1
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
Importance of informing patients of other important precautionary information.1 (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Tablets, extended-release, film-coated
Nisoldipine Extended-release Tablets
Nisoldipine Extended-release Tablets
Nisoldipine Extended-release Tablets
Nisoldipine Extended-release Tablets
AHFS DI Essentials. © Copyright 2019, Selected Revisions January 6, 2015. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
1. First Horizon.Sular (nisoldipine) extended-release tablets prescribing information. (dated 2004 Mar). In: Physicians' desk reference. From the PDR electronic library website. Accessed 2006 Nov 9. http://pdrel.thomsonhc.com
2. Zannad F. Clinical pharmacology of nisoldipine coat core. Am J Cardiol. 1995; 75:41-5E.
3. Mitchell J, Frishman W, Heiman M. Nisoldipine: a new dihydropyridine calcium-channel blocker. J Clin Pharmacol. 1993; 33:46-52. http://www.ncbi.nlm.nih.gov/pubmed/8429113?dopt=AbstractPlus
4. Knorr AM. Why is nisoldipine a specific agent in ischemic left ventricular dysfunction? Am J Cardiol. 1995; 75:36-40E.
5. Fujii Y, Hattori S, Nagami K et al. The hypotensive effect of nisoldipine: 24-hour blood pressure profile and serial alterations of renal and hormonal function. Curr Ther Res. 1994; 55:93-101.
6. Ishiguro M, Shimabukuro S, Minagawa T et al. Evaluation of nisoldipine by noninvasive ambulatory blood pressure monitoring in patients with hypertension. Curr Ther Res. 1991; 50:804-11.
7. Nakanishi T, Takahashi H, Yoshimura M et al. Effects of nisoldipine on ambulatory blood pressure in patients with essential hypertension. Curr Ther Res. 1991; 50:417-24.
8. Shionoiri H, Sugiyama K, Takasaki I et al. Antihypertensive effects of nisoldipine in patients with essential hypertension. Curr Ther Res. 1989; 45:253-61.
9. Lewis BS. Efficacy and safety of nisoldipine coat core in the management of angina pectoris, systemic hypertension, and ischemic ventricular dysfunction. Am J Cardiol. 1995; 75:46E-53E. http://www.ncbi.nlm.nih.gov/pubmed/7726125?dopt=AbstractPlus
10. Glasser SP. Nisoldipine coat core as concomitant therapy in chronic stable angina pectoris. Am J Cardiol. 1995; 75:68-70E.
11. Shaw-Stiffel TA, Walker SE, Ogilvie RI et al. Pharmacokinetic and pharmacodynamic interactions during multiple-dose administration of nisoldipine and propranolol. Clin Pharmacol Ther. 1994; 55:661-9. http://www.ncbi.nlm.nih.gov/pubmed/8004882?dopt=AbstractPlus
12. Rosenfeld JB, Zabludowski J. The efficacy and tolerability of nifedipine (NIF) and nisoldipine (NIS) both alone and combined with a beta-blocker in patients with essential hypertension: a multicenter, parallel-group study. J Clin Pharmacol. 1989; 29:1013-16. http://www.ncbi.nlm.nih.gov/pubmed/2574728?dopt=AbstractPlus
14. Alderman MH. Which antihypertensive drugs first—and why! JAMA. 1992; 267:2786-7. Editorial.
15. Glasser SP, Clark PI, Lipicky RJ et al. Exposing patients with chronic, stable, exertional angina to placebo periods in drug trials. JAMA. 1991; 265:1550-4. http://www.ncbi.nlm.nih.gov/pubmed/1671885?dopt=AbstractPlus
16. National Heart, Lung, and Blood Institute. NHLBI panel reviews safety of calcium channel blockers. Rockville, MD; 1995 Aug 31. Press release.
17. National Heart, Lung, and Blood Institute. New analysis regarding the safety of calcium-channel blockers: a statement for health professionals from the National Heart, Lung, and Blood Institute. Rockville, MD; 1995 Sep 1.
18. Anon. NHLBI panel stands by JNC V in response to Circulation CCB article; AIM report supports use of beta blockers for prevention of sudden cardiac death. F-D-C Rep. 1995; 57(Sep 4):3- 4.
19. American Heart Association. Public advisory statement on calcium channel blocker drugs. Dallas, TX; 1995 Aug 28.
20. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995; 274:620-5. http://www.ncbi.nlm.nih.gov/pubmed/7637142?dopt=AbstractPlus
21. Psaty BM, Heckbert SR, Koepsell TD et al. The risk of incident myocardial infarction associated with anti-hypertensive drug therapies. Circulation. 1995; 91:925.
22. Buring JE, Glynn RJ, Hennekens CH. Calcium channel blockers and myocardial infarction: a hypothesis formulated but not yet tested. JAMA. 1995; 274:654- 5. http://www.ncbi.nlm.nih.gov/pubmed/7637148?dopt=AbstractPlus
23. Furberg CD, Psaty BM, Meyer JV. Nifedipine: dose-related increase in mortality in patients with coronary heart disease. Circulation. 1995; 92:1326-31. http://www.ncbi.nlm.nih.gov/pubmed/7648682?dopt=AbstractPlus
24. Opie LH, Messerli FH. Nifedipine and mortality: grave defects in the dossier. Circulation. 1995; 92:1068-73. http://www.ncbi.nlm.nih.gov/pubmed/7648646?dopt=AbstractPlus
25. Kloner RA. Nifedipine in ischemic heart disease. Circulation. 1995; 92:1074-8. http://www.ncbi.nlm.nih.gov/pubmed/7648647?dopt=AbstractPlus
26. Yusuf S. Calcium antagonists in coronary artery disease and hypertension: time for reevaluation? Circulation. 1995; 92:1079-82. Editorial.
27. Lenfant C. The calcium channel blocker scare: lessons for the future. Circulation. 1995; 91:2855-6. http://www.ncbi.nlm.nih.gov/pubmed/7796490?dopt=AbstractPlus
28. Habib GB. Are calcium antagonists harmful in hypertensive patients? Distinguishing hype from reality. Chest. 1995; 108:3-5. http://www.ncbi.nlm.nih.gov/pubmed/7606987?dopt=AbstractPlus
29. Horton R. Spinning the risks and benefits of calcium antagonists. Lancet. 1995; 346:586- 7. http://www.ncbi.nlm.nih.gov/pubmed/7650997?dopt=AbstractPlus
30. Yusuf S, Held P, Furberg C. Update of effects of calcium antagonists in myocardial infarction or angina in light of the Second Danish Verapamil Infarction Trial (DAVIT-II) and other recent studies. Am J Cardiol. 1991; 67:1295-7. http://www.ncbi.nlm.nih.gov/pubmed/2035457?dopt=AbstractPlus
31. Egstrup K, Andersen PE Jr. Transient myocardial ischemia during nifedipine therapy in stable angina pectoris, and its relation to coronary collateral flow and comparison with metoprolol. Am J Cardiol. 1993; 71:177- 83. http://www.ncbi.nlm.nih.gov/pubmed/8421980?dopt=AbstractPlus
32. Wagenknecht LE, Furberg CD, Hammon JW et al. Surgical bleeding: unexpected effect of a calcium antagonist. BMJ. 1995; 310:776-7. http://www.ncbi.nlm.nih.gov/pubmed/7711582?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=2549165&blobtype=pdf
33. Miles Inc. American Heart Association, Dr. Psalty and Miles Inc. release statements qualifying possible risks of calcium channel blockers. West Haven, CT; 1995 Mar 15. Press release.
34. Dear healthcare professional letter regarding calcium-channel blockers and increased risk of heart attack. Chicago: Searle. 1995 Mar 17.
35. McClellan K. Unexpected results from MIDAS in atherosclerosis. Inpharma Wkly. 1994; Apr 9:4.
36. Anon. Groups act to dispel concerns about calcium-channel blockers. Am J Health-Syst Pharm. 1995; 52:1154, 1158. http://www.ncbi.nlm.nih.gov/pubmed/7656105?dopt=AbstractPlus
37. Waters D. Proischemic complications of dihydropyridine calcium channel blockers. Circulation. 1991; 84:2598-600. http://www.ncbi.nlm.nih.gov/pubmed/1959210?dopt=AbstractPlus
38. Messerli FH. Case-control study, meta-analysis, and bouillabaisse: putting the calcium antagonist scare into context. Ann Intern Med. 1995; 123:888-9. http://www.ncbi.nlm.nih.gov/pubmed/7486476?dopt=AbstractPlus
39. Reviewers’ comments (personal observations) on Nifedipine 24:28.
40. Held PH, Yusuf S, Furberg CD. Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ. 1989; 299:1187-92. http://www.ncbi.nlm.nih.gov/pubmed/2513047?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=1838102&blobtype=pdf
41. Weber MA, Laragh JH. Hypertension: steps forward and steps backward: the Joint National Committee fifth report. Arch Intern Med. 1993; 153:149-52. http://www.ncbi.nlm.nih.gov/pubmed/8422205?dopt=AbstractPlus
42. Anon. Nisoldipine—a new calcium channel blocker for hypertension. Med Lett Drugs Ther. 1996; 38:13-4. http://www.ncbi.nlm.nih.gov/pubmed/8592476?dopt=AbstractPlus
43. Anon. grapefruit juice interactions with drugs. Med Lett Drugs Ther. 1995; 37:73-4. http://www.ncbi.nlm.nih.gov/pubmed/7630329?dopt=AbstractPlus
44. Bailey DG, Arnold JMO, Strong HA et al. Effect of grapefruit juice and naringin on nisoldipine pharmacokinetics. Clin Pharmacol Ther. 1993; 54:589-94. http://www.ncbi.nlm.nih.gov/pubmed/8275614?dopt=AbstractPlus
45. Kaplan NM, Gifford RW. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-9. http://www.ncbi.nlm.nih.gov/pubmed/8622249?dopt=AbstractPlus
46. Zeneca Pharmaceuticals, Wilmington, DE: Personal communication.
47. Chandler MHH, Clifton GD, Lettieri JT et al. Multiple dose pharmacokinetics of four different doses of nisoldipine in hypertensive patients. J Clin Pharmacol. 1992; 32:571-5. http://www.ncbi.nlm.nih.gov/pubmed/1634646?dopt=AbstractPlus
48. Marazzi P. A study to demonstrate the equivalence in efficacy and safety of once-daily nisoldipine CC and amlodipine in the treatment of mild to moderate hypertension. Acta Ther. 1996; 22:23-35.
49. Lasseter KC, Muller FO, Garrett BN et al. Pharmacokinetics, pharmacodynamics, and clinical utility of nisoldipine coat core in the treatment of essential hypertension. Cardiovasc Rev Rep. 1996; 17:28,31-35,38,44-46.
51. Kaplan NM. Choice of initial therapy for hypertension. JAMA. 1996; 275:1577-80. http://www.ncbi.nlm.nih.gov/pubmed/8622249?dopt=AbstractPlus
52. Psaty BM, Smith NL, Siscovich DS et al. Health outcomes associated with antihypertensive therapies used as first-line agents: a systematic review and meta-analysis. JAMA. 1997; 277:739-45. http://www.ncbi.nlm.nih.gov/pubmed/9042847?dopt=AbstractPlus
53. American College of Cardiology and American Heart Association. ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol. 1996; 28:1328-428. http://www.ncbi.nlm.nih.gov/pubmed/8890834?dopt=AbstractPlus
55. Estacio RO, Jeffers BW, Hiatt WR et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med. 1998; 338:645-52. http://www.ncbi.nlm.nih.gov/pubmed/9486993?dopt=AbstractPlus
56. Pahor M, Psaty BM, Furberg CD. Treatment of hypertensive patients with diabetes. Lancet. 1998; 351:689-90. http://www.ncbi.nlm.nih.gov/pubmed/9504510?dopt=AbstractPlus
57. Tatti P, Pahor M, Byington RP et al. Outcome results of the Fosinopril versus Amlodipine Cardiovascular Events randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care. 1998; 21:597-603. http://www.ncbi.nlm.nih.gov/pubmed/9571349?dopt=AbstractPlus
58. Byington RP, Craven TE, Furberg CD et al. Isradipine, raised glycosylated haemoglobin, and risk of cardiovascular events. Lancet. 1997; 350:1075-6. http://www.ncbi.nlm.nih.gov/pubmed/10213554?dopt=AbstractPlus
59. Alderman M, Madhavan S, Cohen H. Calcium antagonists and cardiovascular events in patients with hypertension and diabetes. Lancet. 1998; 351:216-7. http://www.ncbi.nlm.nih.gov/pubmed/9449897?dopt=AbstractPlus
60. Josefson D. Infarction risk found with calcium channel blocker. BMJ. 1998; 316:797.
61. Cutler JA. Calcium-channel blockers for hypertension—uncertainty continues. N Engl J Med. 1998; 338:679-81. http://www.ncbi.nlm.nih.gov/pubmed/9486999?dopt=AbstractPlus
62. Bayer, West Haven, CT: Personal communication.
63. Bakris GL, Copley JB, Vicknair N et al. Calcium channel blockers versus other antihypertensive therapies on progression of NIDDM associated nephropathy. Kidney Int. 1996; 50:1641-50. http://www.ncbi.nlm.nih.gov/pubmed/8914031?dopt=AbstractPlus
64. Velussi M, Brocco E, Frigato F et al. Effects of cilazapril and amlodipine on kidney function in hypertensive NIDDM patients. Diabetes. 1996; 45:216-22. http://www.ncbi.nlm.nih.gov/pubmed/8549868?dopt=AbstractPlus
65. Reviewers’ comments (personal observations).
66. Ameer B, Weintraub RA. Drug interactions with grapefruit juice. Clin Phramacokinet. 1997; 33:103-21.
67. Roller L. Drugs and grapefruit juice. Clin Pharmacol Ther. 1998; 63:87. http://www.ncbi.nlm.nih.gov/pubmed/9465845?dopt=AbstractPlus
68. Spence JD. Drugs and grapefruit juice. Clin Pharmacol Ther. 1998; 63:87-8. http://www.ncbi.nlm.nih.gov/pubmed/9465845?dopt=AbstractPlus
69. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. http://www.ncbi.nlm.nih.gov/pubmed/10818056?dopt=AbstractPlus
70. Frohlich ED. Recognition of systolic hypertension for hypertension. Hypertension. 2000; 35:1019-20. http://www.ncbi.nlm.nih.gov/pubmed/10818055?dopt=AbstractPlus
71. Bakris GL, Williams M, Dworkin L et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000; 36:646-61. http://www.ncbi.nlm.nih.gov/pubmed/10977801?dopt=AbstractPlus
72. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. http://www.diabetes.org/newsroom/
73. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-60. http://www.ncbi.nlm.nih.gov/pubmed/12479770?dopt=AbstractPlus
74. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-riskhypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. http://www.ncbi.nlm.nih.gov/pubmed/12479763?dopt=AbstractPlus
79. Carter B for the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC). Personal communication.
80. Wright JT, Dunn JK, Cutler JA et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005; 293:1595-607. http://www.ncbi.nlm.nih.gov/pubmed/15811979?dopt=AbstractPlus
81. Neaton JD, Kuller LH. Diuretics are color blind. JAMA. 2005; 293:1663-6. http://www.ncbi.nlm.nih.gov/pubmed/15811986?dopt=AbstractPlus
82. Leenen FHH, Nwachuku CE, Black HR et al. Clinical events in high-risk hypertensive patients randomly assigned to calcium-channel blocker versus angiotensin-converting enzyme inhibitor in the Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial. Hypertension. 2006; 48:374-84. http://www.ncbi.nlm.nih.gov/pubmed/16864749?dopt=AbstractPlus
83. Messerli FH, Staessen JA. Amlodipine better than lisinopril: how one randomized clinical trial ended fallacies from observational studies? Hypertension. 2006; 48:359-61. Editorial.
84. US Food and Drug Administration. Center for Drug Evaluation and Research. Approval package for application number 20-356/S-019. From FDA website. http://www.accessdata.fda.gov/drugsatfda_docs/nda/2008/020356Orig1s019.pdf
500. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institutes of Health; 2004 Aug. (NIH publication No. 04-5230.)
501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. http://www.ncbi.nlm.nih.gov/pubmed/24352797?dopt=AbstractPlus
502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. http://www.ncbi.nlm.nih.gov/pubmed/23817082?dopt=AbstractPlus
503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. http://www.ncbi.nlm.nih.gov/pubmed/24243703?dopt=AbstractPlus
504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. http://www.ncbi.nlm.nih.gov/pubmed/24341872?dopt=AbstractPlus
505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. http://www.ncbi.nlm.nih.gov/pubmed/24424788?dopt=AbstractPlus
506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. http://www.ncbi.nlm.nih.gov/pubmed/24549531?dopt=AbstractPlus
507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. http://www.ncbi.nlm.nih.gov/pubmed/24352710?dopt=AbstractPlus
508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. http://www.ncbi.nlm.nih.gov/pubmed/24352759?dopt=AbstractPlus
510. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet. 1997; 350:757-64. http://www.ncbi.nlm.nih.gov/pubmed/9297994?dopt=AbstractPlus
511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. http://www.ncbi.nlm.nih.gov/pubmed/19139601?dopt=AbstractPlus
515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. http://www.ncbi.nlm.nih.gov/pubmed/24591473?dopt=AbstractPlus
516. Wright JT, Bakris G, Greene T et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002; 288:2421-31. http://www.ncbi.nlm.nih.gov/pubmed/12435255?dopt=AbstractPlus
520. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014; 37 Suppl 1:S14-80.
522. Patel A, ADVANCE Collaborative Group, MacMahon S et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007; 370:829-40. http://www.ncbi.nlm.nih.gov/pubmed/17765963?dopt=AbstractPlus
523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.
524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327.
525. Smith SC, Benjamin EJ, Bonow RO et al. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011; 124:2458-73. http://www.ncbi.nlm.nih.gov/pubmed/22052934?dopt=AbstractPlus
526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. http://www.ncbi.nlm.nih.gov/pubmed/24788967?dopt=AbstractPlus
527. O'Gara PT, Kushner FG, Ascheim DD et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362-425. http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3695607&blobtype=pdf
530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. http://www.ncbi.nlm.nih.gov/pubmed/24641124?dopt=AbstractPlus
535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. http://www.ncbi.nlm.nih.gov/pubmed/23684145?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3929429&blobtype=pdf
536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.
541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. http://www.ncbi.nlm.nih.gov/pubmed/22555213?dopt=AbstractPlus
600. Shionogi. Sular (nisoldipine) film-coated, extended-release tablets prescribing information. Florham Park, NJ; 2014 Mar
601. Heinig R. Clinical pharmacokinetics of nisoldipine coat-core. Clin Pharmacokinet. 1998; 35:191-208. http://www.ncbi.nlm.nih.gov/pubmed/9784933?dopt=AbstractPlus
602. Heinig R. Ahr G, Hayauchi Y et al. Pharmacokinetics of the controlled-release nisoldipine coat-core tablet formulation. Int J Clin Pharmacol. 1997; 35:341-51.
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