Document Detail

Plasma renin activity and aldosterone concentration are not altered by the novel calcium channel antagonist, azelnidipine, in hypertensive patients.
MedLine Citation:
PMID:  20371952     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: In hypertensive patients, primary aldosteronism (PA) is the most prevalent type of secondary hypertension, and screening for PA has become very important. Calcium channel blockers (CCB) are widely used to treat hypertension, but most CCBs stimulate plasma renin activity (PRA) and increase plasma aldosterone concentration (PAC), both of which are used in the screening for PA. The aim of this study was to determine whether the newly introduced CCB, azelnidipine, affects PRA and PAC. METHODS: 40 hypertensive patients were treated with 16 mg of azelnidipine for 4 weeks. RESULTS: Azelnidipine treatment in drug-naïve (DN) cases significantly decreased systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR). PRA and PAC in the DN group on azelnidipine treatment were indistinguishable from those in the DN group before treatment. Compared with other CCB treatments such as amlodipine, manidipine and slow-release nifedipine, azelnidipine showed comparable or significant reductions in SBP, DBP and HR. In patients who were switched from other CCBs to azelnidipine, PRA and PAC were decreased, except for PAC on amlodipine treatment. Since the PRA reduction rate exceeded that of PAC, the aldosterone/renin ratio (ARR) was significantly increased in those on azelnidipine treatment who had been switched from manidipine or nifedipine treatment, suggesting the restoration of possibly underestimated ARR values. CONCLUSION: These data indicate that azelnidipine does not affect PRA or PAC, suggesting that azelnidipine could be a useful antihypertensive CCB while undergoing PA screening.
Tatsuya Kondo; Rieko Goto; Kazuhiro Sonoda; Takeomi Yasuda; Kaoru Ono; Yuki Takaki; Riichiro Yatsuda; Nobuhiro Miyamura; Eiichi Araki
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-01
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  49     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2010  
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  637-43     Citation Subset:  IM    
Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto.
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MeSH Terms
Aged, 80 and over
Aldosterone / blood*
Azetidinecarboxylic Acid / analogs & derivatives*,  pharmacology,  therapeutic use
Blood Pressure / drug effects,  physiology
Calcium Channel Blockers / pharmacology,  therapeutic use*
Dihydropyridines / pharmacology,  therapeutic use*
Heart Rate / drug effects,  physiology
Hypertension / blood*,  drug therapy*
Middle Aged
Renin / blood*
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Dihydropyridines; 123524-52-7/azelnidipine; 2517-04-6/Azetidinecarboxylic Acid; 52-39-1/Aldosterone; EC

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