| A new-generation N/L-type calcium channel blocker leads to less activation of the renin-angiotensin system compared with conventional L type calcium channel blocker. | |
| | |
MedLine Citation:
|
PMID: 20625317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Calcium channel blocker (CCB) is one of the most useful antihypertensive agents. However, the activation of the renin-angiotensin system (RAS) is an unfavorable characteristic. N-type calcium channel is thought to be involved in catecholamine's release. Accordingly, N/L-type CCB has a probability of less activation of the RAS. We substantiated the hypothesis that N/L-type CCB, cilnidipine, leads to less activation of the RAS compared with conventional L-type CCB, amlodipine. DESIGN: Randomized, cross-over study. SETTING: Outpatient study. PARTICIPANTS: Participants were 110 hypertensive patients [male/female 46/64, age 66.3 ± 10.8 years, systolic blood pressure (SBP)/diastolic blood pressure (DBP) 161.8 ± 16.9/92.9 ± 12.4 mmHg, s-Cr 0.77 ± 0.32 mg/dl, plasma renin activity (PRA) 0.65 ± 0.63 ng/ml per h, angiotensin I (AngI) 70.5 ± 77.3 pg/ml, angiotensin II (AngII) 5.2 ± 3.9 pg/ml, plasma aldosterone concentration (PAC) 76.3 ± 35.9 pg/ml, urinary albumin excretion (UAE) 108.1 ± 284.2 mg/gCr]. Amlodipine besilate or cilnidipine was administered for 12 weeks in a cross-over manner as a monotherapy with an intention-to-treat fashion by titrating doses. Final doses of amlodipine besilate and cilnidipine were 6.6 ± 2.7 and 13.7 ± 5.1 mg/day, respectively. MAIN OUTCOME MEASURES: Changes in blood pressure, PRA, AngI, AngII, PAC, UAE of baseline and each end of amlodipine besilate and cilnidipine administration. RESULTS: Results were as follows (amlodipine vs. cilnidipine): SBP/DBP (mmHg): 135.2 ± 11.7/79.8 ± 9.6 vs. 136.7 ± 13.2/79.5 ± 10.9, P = 0.22/0.74; PRA (ng/ml per h): 1.16 ± 1.03 vs. 0.95 ± 0.78, P < 0.01; AngI (pg/ml): 155.0 ± 306.4 vs. 101.8 ± 92.0, P < 0.05; AngII (pg/ml): 12.0 ± 12.3 vs. 7.1 ± 4.5, P < 0.001; PAC (pg/ml): 81.6 ± 37.9 vs. 74.3 ± 36.2, P < 0.05; UAE (mg/gCr): 145.4 ± 424.5 vs. 58.8 ± 125.1, P < 0.05. Thus, in spite of the comparable blood pressure reductions, each level of components of the RAS at cilnidipine administration was significantly lower than those at amlodipine. Apart from this, UAE at cilnidipine administration was also significantly lower than that at amlodipine. CONCLUSION: It is suggested that cilnidipine leads to less activation of the RAS compared with amlodipine for the first time in human clinical patients and therefore cilnidipine might be expected to be superior in organ protection in addition to the antialbuminuric effect. |
| | |
Authors:
|
Tadashi Konoshita; Yasukazu Makino; Tomoko Kimura; Miki Fujii; Shigeyuki Wakahara; Kenichiro Arakawa; Isao Inoki; Hiroyuki Nakamura; Isamu Miyamori; |
Related Documents
:
|
18832257 - Aliskiren for hypertension in adults. 998517 - Increased plasma catecholamines in high renin hypertension. 8901817 - Pressure-dependent renin release during chronic blockade of nitric oxide synthase. 6757027 - Impairment of blood pressure control in patients with liver cirrhosis during tilting: s... 22543017 - Pulmonary function and expiratory flow limitation in acute cervical cord injury. 8292057 - Effect of a new calcium antagonist on hemodynamics at rest and exercise loading in pati... |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of hypertension Volume: 28 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-16 Completed Date: 2011-01-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
|
Languages: eng Pagination: 2156-60 Citation Subset: IM |
Affiliation:
|
Third Department of Internal Medicine, Fukui University School of Medicine, Eiheiji, Fukui 910-1193, Japan. konosita@u-fukui.ac.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Albuminuria / physiopathology Aldosterone / blood Amlodipine / pharmacology*, therapeutic use Angiotensin I / blood Angiotensin II / blood Blood Pressure / drug effects, physiology Calcium Channel Blockers / pharmacology*, therapeutic use Cross-Over Studies Dihydropyridines / pharmacology*, therapeutic use Dose-Response Relationship, Drug Female Humans Hypertension / blood, drug therapy, physiopathology* Male Middle Aged Renin / blood Renin-Angiotensin System / drug effects*, physiology |
| Chemical | |
Reg. No./Substance:
|
0/Calcium Channel Blockers; 0/Dihydropyridines; 11128-99-7/Angiotensin II; 132203-70-4/cilnidipine; 52-39-1/Aldosterone; 88150-42-9/Amlodipine; 9041-90-1/Angiotensin I; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Contribution of D4-F to ABCA1 expression and cholesterol efflux in THP-1 macrophage-derived foam cel...
Next Document: Beneficial cardiac effects of the renin inhibitor aliskiren in spontaneously hypertensive rats.