COMPARISON OF HEMODYNAMIC AND VASCULAR PARAMETERS BETWEEN PATIENTS WITH CKD AND ASSOCIATED HYPERTENSION TREATED WITH AMLODIPINE AND CILNIDIPINE

Dr. Geeta Sheth, Dr. Shahid Ansari

Abstract


Background: Hypertension is more prevalent in patients with chronic kidney disease (CKD) and has a
strong risk of cardiovascular disease. This study was aimed to assess and compare amlodipine with
cilnidipine on hemodynamic parameters of central blood pressure and arterial stiffness in patients with CKD on dialysis and
with associated hypertension.
Methods: This was a prospective study conducted between October 2018 and October 2019. Patients of either sex with CKD on
dialysis and with associated hypertension and receiving either amlodipine or cilnidipine were included in the study. Mobil-O-
® Graph PWA was used assess peripheral BP, vascular age, augmentation index (AI) and pulse wave velocity (PWV).
Results: A total of 87 patients were included (group 1, amlodipine, n=55; group 2, cilnidipine, n=22). The majority of patients
were men (n=55). Proportion of patients with normal, average and abnormal vascular age and arterial stiffness was
comparable between the treatment groups. However, in amlodipine group, frequency of patients with normal vascular age
(42.2% vs 31.8%) was comparatively higher and frequency of patients with average vascular age (32.8% vs 40.9%) was
comparatively lower, compared to cilnidipine group.
Conclusion: Both amlodipine and cilnidipine showed equal efcacy on hemodynamic parameters of central blood pressure
and arterial stiffness in studied population


Keywords


Augmentation index, blood pressure, cardiovascular, pulse wave

Full Text:

PDF

References


Protogerou, A., Blacher, J., Stergiou, G. S., Achimastos, A., & Safar, M. E. (2009). Blood pressure response under chronic antihypertensive drug therapy: the role of aortic stiffness in the REASON (Preterax in Regression of Arterial Stiffness in a Controlled Double-Blind) study. J Am Coll Cardiol, 53(5), 445-451. https://doi.org/ 10.1016/j.jacc.2008.09.046

Nguyen, Q., Dominguez, J., Nguyen, L., & Gullapalli, N. (2010). Hypertension management: an update. Am Health Drug Benefits, 3(1), 47–56. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106550/

Safar, M. E., Pannier, B., Laurent, S., & London, G. M. (1989). Calcium-entry blockers and arterial compliance in hypertension. J Cardiovasc Pharmacol, 14(Suppl 10): S1-6, discussion S59-62. https://doi.org/ 10.1097/00005344-198906151-00002

Kim, K. H., Jeong, M. H., Cho, S. H., Moon, J.Y., Hong, Y. J., Park, H. W., Kim, J. H., Ahn, Y., Cho, J. G., Park, J. C., & Kang, J. C. (2009). Clinical effects of calcium channel blocker and Angiotensin converting enzyme inhibitor on endothelial function and arterial stiffness in patients with angina pectoris. Journal of Korean medical science, 24(2), 223-231. https://doi.org/10.3346/jkms.2009.24.2.223

Takahara, A. (2009). Cilnidipine: a new generation Ca channel blocker with inhibitory action on sympathetic neurotransmitter release. Cardiovasc Ther, 27(2), 124-139. https://doi.org/10.1111/j.1755-5922.2009.00079.x

Babu, K. A. (2017). Assessment of efficacy of amlodipine with cilnidipine in hypertensive patients: a comparative study. Int J Contemporary Med Research, 4(4), 956-958. https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1416_may_20.pdf

Adake, P., Somashekar, H. S., Mohammed Rafeeq, P. K., Umar D., Basheer, B., & Baroudi, K. (2015). Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: A prospective study. J Adv Pharm Technol Res, 6(2), 81-85. https://doi.org/10.4103/2231-4040.154543.

Morimoto, S., Yano, Y., Maki, K., & Iwasaka, T. (2007). Renal and vascular protective effects of cilnidipine in patients with essential hypertension. J Hypertens, 25(10), 2178-2183. https://doi.org/10.1097/HJH.0b013e3282c2fa62

Pathapati, R. M., Rajashekar, S. T., Buchineni, M., Meriga, R. K., Reddy, C. B., & Kumar, K. P. (2015). An Open Label Parallel Group Study to Assess the Effects of Amlodipine and Cilnidipine on Pulse Wave Velocity and Augmentation Pressures in Mild to Moderate Essential Hypertensive Patients. J Clin Diagn Res, 9(11), FC13-6. https://doi.org/10.7860/JCDR/2015/12702.6754

Zaman, Z. A., & Kumari, V. (2017). Comparison of the effects of amlodipine and cilnidipine on blood pressure, heart rate, proteinuria and lipid profile in hypertensive patients. Int J Basic Clin Pharmacol, 2(2), 160-164. https://doi.org/10.5455/2319-2003.ijbcp20130308

Fujita, T., Ando, K., Nishimura, H., Ideura, T., Yasuda, G., & Takahashashi, K. (2007). Antiproteinuric effect of the calcium channel blocker Cilnidipine added to rennin angiotensin inhibition in hypertensive patients with chronic renal disease. Kidney Int, 72(2), 1543-1549. https://doi.org/10.1038/sj.ki.5002623

Uchida, S., Takahashi, M., Sugawara, M., Saito, T., Nakai, K., Fujita, M., Mochizuki, K., Shin, I., Morita, T., Hikita, T., Itakura, H., Takahashi, Y., Mizuno, S., Ohno, Y., Ito, K., Ito, T., & Soma, M. (2014). Effects of the N/L-type calcium channel blocker cilnidipine on nephropathy and uric acid metabolism in hypertensive patients with chronic kidney disease (J-CIRCLE study). J Clin Hypertens (Greenwich), 16(10), 746-753. https://doi.org/10.1111/jch.12412

Malleshappa, P. (2013). Cilnidipine effectively reduces low-grade albuminuria in hypertensive chronic kidney disease patients. Dial Traspl, 34(1), 2-6. https://doi.org/ 10.1016/j.dialis.2012.04.001

Soeki, T., Kitani, M., Kusunose, K., Yagi, S., Taketani, Y., Koshiba, K., Wakatsuki, T., Orino, S., Kawano, K., & Sata, M. (2012). Renoprotective and antioxidant effects of cilnidipine in hypertensive patients. Hypertens Res, 35(11), 1058-1062. https://doi.org/10.1038/hr.2012.96

Kanaoka, T., Tamura, K., Wakui, H., Ohsawa, M., Azushima, K., Uneda, K., Kobayashi, R., Fujikawa, T., Tsurumi-Ikeya, Y., Maeda, A., Yanagi, M., Toya, Y., & Umemura, S. (2013). 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. Int J Mol Sci, 14(8), 16866-16881. https://doi.org/10.3390/ijms140816866.


Refbacks

  • There are currently no refbacks.