Reduction of white coat effect by cilnidipine in essential hypertension

Abstract

Stress elevates blood pressure (BP) by increased sympathetic nerve activity. Cilnidipine, a novel dihydropyridine calcium antagonist that has inhibitory actions on N-type as well as L-type voltage-dependent calcium channels, has been reported to attenuate the cold stress-induced increase in plasma norepinephrine and BP in rats. Because white coat effect is associated with an enhanced pressor response to mental stress, we postulated that cilnidipine would attenuate white coat effect in patients with essential hypertension. Sixty-one consecutive outpatients (50 men, 11 women) with essential hypertension were studied prospectively. Twenty-nine patients were treated with either cilnidipine (n = 15) or nifedipine, a representative L-type voltage-dependent calcium antagonist (n = 14). Gender, age, body mass index, duration of hypertension, target organ damage of hypertension, and BP and heart rate (HR) were not significantly different between cilnidipine and nifedipine groups, and both systolic (SBP) and diastolic BP (DBP) were significantly decreased after treatment in both groups. White coat effects on systolic and DBP and HR were not significantly different between groups before antihypertensive treatment. Cilnidipine, but not nifedipine, significantly reduced white coat effects on SBP and HR. Furthermore, white coat effects on systolic BP and HR were significantly lower after treatment in the cilnidipine group compared with the nifedipine group. These data suggest that cilnidipine may reduce white coat effect in hypertensive patients by N-type calcium channel antagonism.

Comparison of the effects of amlodipine and cilnidipine on blood pressure, heart rate, proteinuria and lipid profile in hypertensive patients

“…20,21 There was a significant negative correlation between the degree of SBP change and that of PR change after Cilnidipine treatment. This finding is an agreement with several previous studies 22,23 in which Cilnidipine suppressed sympathetic nervous activity, especially under a stress-induced hyperactive condition.…”

Comparison between Cilnidipine and Amlodipine Besilate with Respect to Proteinuria in Hypertensive Patients with Renal Diseases

“…This finding is in agreement with several previous studies (22)(23)(24)(25) in which cilnidipine suppressed sympathetic nervous activity, especially under a stress-induced hyperactive condition.…”

Comparison of the effects of L-type calcium channel antagonist Amlodipine with L/N-type calcium channel antagonist Cilnidipine on blood pressure, heart rate, proteinuria and lipid profile in hypertensive patients

“…20,21 There was a significant negative correlation between the degree of SBP change and that of PR change after Cilnidipine treatment. This finding is an agreement with several previous studies 22,23 in which Cilnidipine suppressed sympathetic nervous activity, especially under a stress-induced hyperactive condition. Blood pressure control is important in suppressing the onset of renal dysfunction.…”