L/N-Type Calcium Channel Blocker Cilnidipine Added to Renin-Angiotensin Inhibition Improves Ambulatory Blood Pressure Profile and Suppresses Cardiac Hypertrophy in Hypertension with Chronic Kidney Disease

International Journal of Molecular Sciences

Tomohiko Kanaoka¹  Kouichi Tamura²  Hiromichi Wakui¹  Masato Ohsawa¹  Kengo Azushima¹  Kazushi Uneda¹  Ryu Kobayashi¹  Tetsuya Fujikawa¹  Yuko Tsurumi-Ikeya¹  Akinobu Maeda¹  Mai Yanagi¹  Yoshiyuki Toya¹ 

[1]Department of Medical Science and Cardiorenal Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan

关键词: ambulatory blood pressure;    calcium channel blockers;    cardiac hypertrophy;    chronic kidney disease;    heart rate variability;    hypertension (kidney);   

DOI  :  10.3390/ijms140816866

来源: mdpi

【 摘 要 】

Ambulatory blood pressure (BP) and heart rate (HR) profile are proposed to be related to renal deterioration and cardiovascular complication in hypertension and chronic kidney disease (CKD). In this study, we examined the beneficial effects cilnidipine, a unique L/N-type calcium channel blocker (CCB), in addition to renin-angiotensin system inhibitors, on ambulatory BP and HR profile, as well as cardiorenal function in hypertensive CKD patients. Forty-five patients were randomly assigned to the cilnidipine replacement group (n = 21) or the control CCBs group (n = 24) during a 24-week active treatment period. Although clinical BP values were similar in the cilnidipine and control CCBs groups after the treatment period, the results of ambulatory BP monitoring showed that the 24-h and daytime systolic BP levels in the cilnidipine group were significantly lower compared with the control group after the study. Furthermore, the left ventricular mass index (LVMI) was significantly decreased in the cilnidipine group compared to the control group after the study (LVMI, 135.3 ± 26.4 versus 181.2 ± 88.4, p = 0.031), with a significant difference in the changes in the LVMI between the cilnidipine and control groups (change in LVMI, −12.4 ± 23.7 versus 26.2 ± 64.4, p = 0.007). These results indicate that cilnidipine is beneficial for the suppression of pathological cardiac remodeling, at least partly, via a superior improving effect on ambulatory BP profile compared with control CCBs in hypertensive CKD patients.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland