Effects of New Calcium Channel Blocker, Azelnidipine, and Amlodipine on Baroreflex Sensitivity and Ambulatory Blood Pressure

Eguchi, Kazuo; Tomizawa, Hidenori; Ishikawa, Joji; Hoshide, Satoshi; Fukuda, Toshio; Numao, Toshio; Shimada, Kazuyuki; Kario, Kazuomi

doi:10.1097/fjc.0b013e31804d1cf1

Cited by 32 publications

(19 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…our results were consistent with previous reports, which indicate that the ccB used in this study, azelnidipine, suppresses Hr (26). in keeping with the activity of ccBs, azelnidipine has been reported to suppress the increase in Hr by the activation of sympathetic nerve activity induced by a rapid decrease in BP (27). This suppression may be due to the rate of BP lowering (28), or to the direct inactivation of sympathetic nerve activity (29).…”

Section: Bsupporting

confidence: 83%

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Tomita¹

2009

Mol Med Rep

View full text Add to dashboard Cite

Abstract. For hypertension, combination therapies are recommended to acheive a low target blood pressure. in this study, the efficacy of combination therapies for preventing organ damage was investigated in spontaneously hypertensive rats (SHr). Twenty-week-old male SHr were orally administered olmesartan (Olm) (5 mg/kg/day) for the first 4 weeks. Subsequently, rats were randomly divided into 5 groups and administered add-on drugs for another 4 weeks as follows: olm+olm (5 mg/kg/day), olm+azelnidipine (aze) (30 mg/kg/ day), olm+temocapril (Tem) (10 mg/kg/day), olm+atenolol (ate) (5 mg/kg/day), olm+hydrochlorothiazide (HcTZ) (5 mg/kg/ day). Blood pressure and heart rate were measured at weeks 0, 4 and 8 by the tail-cuff method. Heart and kidney weights were determined, and endothelial function was assessed by evaluating the dilator response to acetylcholine. in comparison to untreated control SHR, a significant reduction in systolic blood pressure was observed at weeks 4 and 8 in all groups (p<0.05), while heart rate was significantly reduced at week 8 in only the olm+aze and olm+ate groups (p<0.05). in all groups, heart but not kidney weight was significantly decreased (p<0.05), and endothelial function was significantly improved (p<0.05) compared to the control SHr. in the olm+olm, olm+Tem and olm+aze groups, endothelial function was significantly improved as compared to the other treatment groups (p<0.05). Thus, when using an angiotensin receptor blocker as a first-line therapy, an antihypertensive in the form of an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or calcium channel blocker, such as azelnidipine, should be used as a second-line drug to protect against vascular damage.

show abstract

Section: Bsupporting

confidence: 83%

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Tomita¹

2009

Mol Med Rep

View full text Add to dashboard Cite

show abstract

“…25 Indeed, it is possible that a reduction in BPV by CCB could also contribute to an improvement in arterial stiffness. Considering the pharmacological action of azelnidipine, 17,30 however, it is probable that the CCB-induced reduction in arterial stiffness would lead to reduced home BPV, both directly and through the improvement of baroreflex modulation.…”

Section: Discussionmentioning

confidence: 99%

“…28 On the other hand, because BPV is controlled mainly by arterial baroreflex sensitivity (BRS), 29 one can speculate that CCB's effect on day-by-day home BPV is mediated by improving the BRS. Because it was reported that azelnidipine, a long-acting dihydropyridine-type CCB, could improve the BRS significantly and more than could amlodipine in hypertensives, 30 the add-on treatment of azelnidipine might have reduced the home BPV partly through the improvement of the BRS.…”

Section: Discussionmentioning

confidence: 99%

Combined Effect of Angiotensin II Receptor Blocker and Either a Calcium Channel Blocker or Diuretic on Day-by-Day Variability of Home Blood Pressure

Matsui

O’Rourke²,

Hoshide³

et al. 2012

Hypertension

Self Cite

View full text Add to dashboard Cite

Abstract-Day-by-day home blood pressure (BP) variability (BPV) was reported to be associated with increased cardiovascular risk. We aimed to test the hypothesis that the angiotensin II receptor blocker/calcium-channel blocker combination decreases day-by-day BPV more than the angiotensin II receptor blocker/diuretic combination does and investigated the mechanism underlying the former reduction. We enrolled 207 hypertensive subjects treated with olmesartan monotherapy for 12 weeks. The subjects were randomly assigned to treatment with hydrochlorothiazide (nϭ104) or azelnidipine (nϭ103) for 24 weeks. Home BP was taken in triplicate with a memory-equipped device in the morning and evening, respectively, for 5 consecutive days before each visit. Visits occurred at 4-week intervals. Home BPV was defined as within-individual SD of the 5-day home BP. Arterial stiffness was assessed by aortic pulse wave velocity at baseline and 24 weeks later. The reductions in home systolic BP were similar between the 2 groups, whereas the SD of home systolic BP decreased more in the azelnidipine group than in the hydrochlorothiazide group during the follow-up period (follow-up mean: 6.3 versus 7.1 mm Hg; Pϭ0.007). In the azelnidipine group, the change in aortic pulse wave velocity was independently associated with the change in SD of home systolic BP (regression coefficientϮSEϭ0. 79Ϯ0.37; Pϭ0.036). This study demonstrated that the angiotensin II receptor blocker/calciumchannel blocker combination improved home BPV in addition to home BP reduction and that the reduction in home BPV was partly attributable to the arterial stiffness reduction by this combination. (Hypertension. 2012;59:1132-1138.) • Online Data Supplement Key Words: home blood pressure Ⅲ day-by-day home blood pressure variability Ⅲ calcium channel blocker Ⅲ thiazide diuretic Ⅲ angiotensin II receptor blocker Ⅲ pulse wave velocity T here is a growing body of evidence that visit-to-visit blood pressure (BP) variability (BPV) in a clinical setting was significantly associated with target organ damage [1][2][3][4][5][6] and that it could predict cardiovascular events independent of mean office BP level.7-10 One drawback of the application of visit-to-visit office BPV for the routine clinical management of hypertension is that obtaining it requires several office visits over a period of time. One possible way to solve this is to evaluate day-by-day home BPV, because this selfmeasurement makes it possible to obtain multiple BP values in a relatively short period under well-controlled conditions. 11It was reported recently that the increased day-by-day home BPV, calculated as the SD of home BP, was associated with the severity of target organ damage in patients with hypertension 12 or diabetes mellitus 13 and with cardiovascular mortality in a community-dwelling population.14 After treat- Thus, these results 15,16 raised speculation that the difference in cardiovascular events that favored the CCB regimen was not explained by BP differences but, rather, by the favorable effect...

show abstract

“…As baroreceptor hypersensitivity may play a part in OHT, clonidine may be a useful drug. Some recent studies have suggested that the new calcium channel blocker azelnidipine has greater effect on baroreflex sensitivity compared to the older analogues like amlodipine [47]. More evidence will be required to see if this could have a noticeable effect on target organ damage.…”

Section: Treatment Options For Patients With Ohtmentioning

confidence: 99%

An Emerging Role for Understanding Orthostatic Hyp‘er’tension in the Cardiorenal Syndrome

et al. 2011

View full text Add to dashboard Cite

Orthostatic hypertension (OHT) is a clinically important problem increasingly recognized in persons with borderline hypertension, diabetes mellitus, and autonomic neuropathies, and in the elderly. Moreover, the association of OHT with progression of target end-organ damage, especially coronary heart disease and chronic kidney disease (CKD), and the attendant increased cardiovascular disease (CVD) and CKD risk, is gaining attention but is still underappreciated. There are various mechanisms that contribute to the development of OHT: excessive vascular adrenergic sensitivity, baroreceptor reflex abnormalities, and inappropriate activation of the renin-angiotensin-aldosterone system, which are also mechanisms that lead to cardiorenal metabolic disease (CRS). While the evidence is compelling for the clinical importance of OHT, more investigation is needed to evaluate the effects of OHT on CKD and CVD. The notion that the development of OHT is a risk factor for the development of CRS raises the need for further clinical and investigational attention to this clinical dilemma.

show abstract

Effects of New Calcium Channel Blocker, Azelnidipine, and Amlodipine on Baroreflex Sensitivity and Ambulatory Blood Pressure

Cited by 32 publications

References 40 publications

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Combined Effect of Angiotensin II Receptor Blocker and Either a Calcium Channel Blocker or Diuretic on Day-by-Day Variability of Home Blood Pressure

An Emerging Role for Understanding Orthostatic Hyp‘er’tension in the Cardiorenal Syndrome

Contact Info

Product

Resources

About