Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: A prospective study

Adake, Prabhakar; Somashekar, H.S.; Rafeeq, PK Mohammed; Umar, Dilshad; Basheer, Bahija; Baroudi, Kusai

doi:10.4103/2231-4040.154543

Cited by 20 publications

(18 citation statements)

References 28 publications

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“…In our study, subjects in amlodipine group had a significantly higher incidence of pedal oedema [5 (16.7%)] compared to the cilnidipine group [1 (3.3%)]. Similar observation has been made in a study by Adake P et al 52 among 60 hypertensive patients treated with either amlodipine or cilnidipine. Also, in a study done by Dalvi K et al, 33 many Indian physicians have reported pedal oedema as a common complaint in patients treated with amlodipine, while treatment with cilnidipine minimised pedal oedema.…”

Section: Adverse Effectssupporting

confidence: 90%

A Study of the Effects of Amlodipine and Cilnidipine on Haemodynamic Parameters and Renoprotection in Hypertensive Subjects With Proteinuria

Gowda¹,

Ramesh²

2017

jemds

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BACKGROUND Hypertension with chronic kidney disease is a widely prevalent public health concern. Calcium channel blockers are a commonly used class of drugs for the treatment of hypertension. L-type calcium channel blockers like amlodipine cause a reflex sympathetic overactivity, which predisposes to increased cardiovascular morbidity and mortality. Also, the effect of L-type CCBs on urinary protein excretion is uncertain. Cilnidipine is a novel CCB with a dual L/N-type calcium channel blocking property, thus favouring additional renal and cardiovascular protection. The objective of this study is to evaluate the effects and their linearity across the timeframe of amlodipine and cilnidipine in hypertensive subjects with proteinuria on heart rate, blood pressure, lipid profile and proteinuria. MATERIALS AND METHODS After Institutional Ethical Committee approval, a prospective, randomised and open-label study was carried out on hypertensive subjects with proteinuria attending the General Medicine OPD in K. R. Hospital, Mysore. Sixty subjects satisfying the inclusion and exclusion criteria were included in the study. Heart rate, blood pressure, lipid profile (TC, LDL, HDL, TG) and Urine Protein-to-Creatinine Ratio (UPCR) were measured at baseline. Blood pressure and heart rate were monitored at weekly intervals until the end of 12 weeks. While lipid profile was reassessed at 6 weeks and 12 weeks, UPCR was reassessed at the end of 12 weeks. Descriptive statistics, independent sample 't' test, repeated measure ANOVA and Cramer's V test were used to analyse the results. RESULTS Demographic profile was well matched in both the groups. In the Amlodipine group, the heart rate was significantly higher tha n that before treatment, whereas subjects in the cilnidipine group had a significantly lower heart rate when compared to baseline (p < 0.05). There was no significant difference in mean SBP and mean DBP values, either within each group or between the two groups. Also, the UPCR was significantly decreased in the cilnidipine group as opposed to the amlodipine group where it wa s significantly increased, thereby resulting in a significant intergroup difference (p < 0.05). However, neither of the drugs caused a significant change in the lipid parameters and the intergroup difference was also statistically insignificant. CONCLUSION Cilnidipine is thus, a better alternative in hypertensive patients with proteinuria due to its cardioprotective and renoprotective actions.

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Section: Adverse Effectssupporting

confidence: 90%

A Study of the Effects of Amlodipine and Cilnidipine on Haemodynamic Parameters and Renoprotection in Hypertensive Subjects With Proteinuria

Gowda¹,

Ramesh²

2017

jemds

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“…The current pharmacological options to treat HTN include diuretics, CCBs, ACEIs, ARBs, sympatholytic drugs and vasodilators. The choice of drug therapy will be determined by the severity of diseases and associated patient factors [1,7].…”

Section: Introductionmentioning

confidence: 99%

“…Peripheral edema is uncomfortable, sometimes intolerable and may lead to a decline in patient's quality of life [9,10]. The incidence of pedal edema ranges from 1.7% to 63.3% [7]. Monotherapy showed a higher incidence of pedal edema than the combination therapy [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Causative Factors in Amlodipine Induced Pedal Edema

Shetty

Rao

Vivek

et al. 2016

Int J Pharm Pharm Sci

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Objective: To study the edema causing factors in hypertensive, amlodipine-induced pedal edema patients.Methods: The present was a prospective, observational study. A total of one hundred and twenty-four essential hypertensive patients, of either gender attending the outpatient department of cardiology and medicine, were recruited for this study. Out of the 124 patients, 62 were of the amlodipine-induced pedal edema [AIPE] group and other 62 patients were amlodipine-treated non-edema [ATNE] group. All the patients were receiving a dosage of amlodipine 5 mg/day. All recruited patients completed the study. The present study conducted at Kasturba Hospital, Manipal.Results: The vanillyl mandelic acid (VMA) (mean±SD) 7.08±2.3 mg/24 h and 4.9±1.7 mg/24 h in AIPE and ATNE groups respectively. Blood pressure (BP) and VMA was higher in AIPE group than the ATNE group (p<0.001). Pulse rate (PR), serum proteins, creatinine, sodium, osmolality, did not show any significant difference between the two study groups.Conclusion: In essential hypertensive patients with AIPE group presented with a higher VMA level than the ATNE group. The elevated catecholamine’s possibly the causative factor for AIPE.

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“…We noticed the prominent P wave in cilnidipine treated group than the amlodipine group. The major drawback of amlodipine is the incidence of pedal oedema [3], in such case cilnidipine is more benefit drug with a lesser incidence of pedal oedema and shows the better hypertension control [1]. Cilnidipine is more beneficial than amlodipine as an additional medication for hypertensive patients with Chronic Kidney Diseases (CKD) [17].…”

Section: Discussionmentioning

confidence: 99%

“…Globally, one billion people are suffering from hypertension [1]. In India, about 33% urban and 25% rural populations are hypertensive [2].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study on Clinical and Biochemical Parameters in Amlodipine and Cilnidipine Treated Hypertensive Patients

Shetty

Bairy

et al. 2017

JCDR

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Introduction: Hypertension is a major health issue worldwide. Calcium Channel Blockers (CCBs) are the most commonly used antihypertensive agents. CCBs act on voltage-dependent calcium channels and they were categorized into two subclasses, Dihydropyridine (DHP) and non-Dihydropyridine (non-DHP) derivative. Amlodipine is a third generation L-type of DHP and Cilnidipine is a novel L/N-type of DHP CCB, both drugs have excellent pharmacological profiles with the unique actions. Aim:To study the clinical and biochemical profile in Amlodipine and Cilnidipine treated mild to moderate hypertensive patients.

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Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: A prospective study

Cited by 20 publications

References 28 publications

A Study of the Effects of Amlodipine and Cilnidipine on Haemodynamic Parameters and Renoprotection in Hypertensive Subjects With Proteinuria

A Study of the Effects of Amlodipine and Cilnidipine on Haemodynamic Parameters and Renoprotection in Hypertensive Subjects With Proteinuria

Evaluation of Causative Factors in Amlodipine Induced Pedal Edema

A Comparative Study on Clinical and Biochemical Parameters in Amlodipine and Cilnidipine Treated Hypertensive Patients

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