Primary pulmonary hypertension: effects of nifedipine. Br Heart J

suMMARY The results of the medical treatment of primary pulmonary hypertension are usually very poor. A case of severe primary pulmonary hypertension in chronic heart failure was treated with the calcium antagonist nifedipine, a powerful vasodilator which acts directly on vascular smooth muscle. Nifedipine, administered in a dose of 20 mg sublingually, caused a pronounced fall in pulmonary and systemic vascular resistances (54 and 49%, respectively) and a rise in cardiac output (90.3%). Improvement was maintained over a three-month period. These data suggest that nifedipine can be used in the treatment of this condition. Pulmonary arterial hypertension results from an increase in pulmonary blood flow, augmented resistance, or both. Primary pulmonary hyperten-sion, a rare disease of unknown aetiology and with a progressive fatal course, is characterised by increased pulmonary vascular resistance. Previous experience with vasodilators'-3 and subsequent morphometric studies4 suggest that vasoconstrictio