Natriuretic effect of barnidipine, a long-acting dihydropyridine calcium channel blocker, in patients with essential hypertension

2000 ◽  
Vol 38 (06) ◽  
pp. 304-308 ◽  
Author(s):  
Y. Ohya ◽  
I. Abe ◽  
Y. Ohta ◽  
U. Onaka ◽  
K. Fujii ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Natriuretic Effect ◽  
Long Acting

Effects of Long- and Intermediate-Acting Dihydropyridine Calcium Channel Blockers in Hypertension

2018 ◽  
Vol 23 (5) ◽  
pp. 433-445 ◽  
Author(s):  
Sandip Chaugai ◽  
Lhamo Yangchen Sherpa ◽  
Amir Ali Sepehry ◽  
Scott Reza Jafarian Kerman ◽  
Hisatomi Arima
Keyword(s):  
Heart Failure ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Calcium Channel Blockers ◽  
Lower Risk ◽  
Randomized Clinical Trials ◽  
Channel Blocker ◽  
Channel Blockers ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Long Acting

Background: Dihydropyridine calcium channel blockers are a heterogeneous group of antihypertensive drugs. Long-acting dihydropyridine agent amlodipine is widely used for monotherapy and combination therapy for hypertension in clinical practice, while intermediate-acting dihydropyridine agents have shown inconsistent results in randomized clinical trials (RCTs). Methods and Results: A meta-analysis of 18 RCTs enrolling a total of 80,483 patients with hypertension followed for a mean of 51.4 months was performed. Amlodipine therapy was associated with 25% higher risk of heart failure (relative risk [RR]: 1.25, 95% confidence interval [CI], 1.05-1.49, P = .019) but 17% lower risk of stroke (RR: 0.83, [95% CI, 0.72-0.97], P = .009) without statistically significant effect on acute myocardial infarction (AMI) compared to major alternative antihypertensive therapy (MAAT), including β-blocker, diuretic, angiotensin-converting enzyme inhibitor, or angiotensin-receptor blocker. Intermediate-acting dihydropyridine calcium channel blocker therapy was associated with 25% higher risk of heart failure (RR: 1.25, [95% CI, 1.06-1.47], 0.005, P = .005) and 26% higher risk of AMI (RR: 1.26, [95% CI, 1.05-1.51], 0.019, P = .019) compared to MAAT. Results of the subgroup analysis suggested that the intermediate-acting dihydropyridine calcium channel blocker was associated with higher risk of heart failure (RR: 1.30, [95% CI, 1.08-1.56], P = .005) and AMI (RR: 1.50, [95% CI, 1.01-2.22], P = .043) compared to renin–angiotensin system blockers and a trend toward higher risk of AMI (RR: 1.17, [95% CI, 0.99-1.38], P = .064) compared to conventional therapy, including β-blockers and diuretics. Meta-regression analyses suggested that long-acting dihydropyridine calcium channel blocker is associated with lower risk of AMI ( B: −0.327, [95% CI, −0.530 to −0.123], P = .002) with a trend toward lower risk of stroke ( B: −0.203, [95% CI, −0.410 to 0.003] P = .054). Conclusions: This study suggests that Amlodipine offers greater protection against major complications of hypertension compared to intermediate-acting dihydropyridine calcium channel blockers.

Effects of an Antihypertensive Combination in Japanese Hypertensive Outpatients Based on the Long-Acting Calcium Channel Blocker Benidipine on Vascular and Renal Events: A Sub-Analysis of the COPE Trial

2020 ◽  
Vol 16 ◽  
Author(s):  
Seiji Umemoto ◽  
Toshio Ogihara ◽  
Masunori Matsuzaki ◽  
Hiromi Rakugi ◽  
Kazuyuki Shimada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Rank Test ◽  
Vascular Events ◽  
Treatment Groups ◽  
Β Blocker ◽  
The Difference ◽  
Long Acting

Background: In the trial known as COPE (Combination Therapy of Hypertension to Prevent Cardiovascular Events) three benidipine (a calcium channel blocker; CCB) regimens were compared. Hypertensive Japanese outpatients aged 40–85 years (n=3,293) who did not achieve the target blood pressure of <140/90 mmHg with benidipine 4 mg/day were treated with the diuretic thiazide (n=1,094) or a β-blocker (n=1,089) or an additional angiotensin receptor blocker (ARB; n=1,110). A significantly higher incidence of hard cardiovascular composite endpoints and of fatal or non-fatal strokes was observed in the benidipine-β-blocker group compared to the benidipine-thiazide group. Objective and Methods: We further evaluated the treatment effects of the three benidipine-based regimens on vascular and renal events in a sub-analysis of the COPE patients. Results: A total of 10 vascular events (0.8 per 1,000 person-years) including one aortic dissection (0.1 per 1,000 person-years) and nine cases of peripheral artery disease (0.8 per 1,000 person-years) were documented, as was a total of seven renal events (0.6 per 1,000 person-years). No significant differences in vascular and renal events were revealed among the three treatment groups: vascular events p=0.92 renal events p=0.16 log-rank test. Conclusions: Blood pressure-lowering therapy with benidipine combined with an ARB, β-blocker, or thiazide was similarly effective in the prevention of vascular and renal events in hypertensive outpatients, although there is no enough these events to compare the difference in the three treatment groups.

scholarly journals Effect of Dihydropyridine Calcium-Channel Blocker on Adverse Aortic Events After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

2021 ◽  
Author(s):  
Fan Yang ◽  
Lyufan Chen ◽  
Jitao Liu ◽  
Songyuan Luo ◽  
Caiyun He ◽  
...  
Keyword(s):  
Propensity Score ◽  
Aortic Dissection ◽  
Calcium Channel ◽  
Propensity Score Matching ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Thoracic Endovascular Aortic Repair ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Dihydropyridine Calcium Channel Blocker

Abstract Objectives: This study aimed to evaluate the effect of dihydropyridine calcium-channel blocker (CCB) on adverse aortic events (AAE) in patients undergoing thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). Methods: A retrospective study was conducted on patients undergoing TEVAR of TBAD from January 2010 to December 2017 in our center. Patients were divided into CCB group and non-CCB group according to the postoperative dihydropyridine CCB use. AAE including aorta-relative mortality and reintervention, were compared between these two groups. Propensity score matching analysis was performed to avoid the potential effect of known confounders.Results: Before matching, the study cohort comprised 548 patients, including 435 (79.4%) and 113 (20.6%) patients in the CCB and non-CCB groups, respectively. After matching, 101 patients in each group were eligible for the analysis. In the unmatched cohort, AAE occurred in 52 (12.0%) and 29 (25.7%) patients in the CCB and non-CCB groups, respectively (P < 0.001). In the matched cohort, AAE occurred in 8 (7.9%) and 22 (21.8%) patients in the CCB and non-CCB groups, respectively (P = 0.013). Log-rank test analysis revealed that the levels of freedom from AAE were significantly different between the 2 groups in both the unmatched and matched cohorts (P < 0.001 and P = 0.007, respectively). Multivariable analysis showed that CCB use (hazard ratio 0.50, 95% confidence interval 0.32–0.80; P = 0.003) was associated with a lower AAE rate after adjustment for other variables, and was minimally changed after the propensity score matching (HR 0.34, 95% CI 0.15–0.75; P = 0.008).Conclusions: Postoperative dihydropyridine CCB use is protective in patients undergoing TEVAR for acute and sub-acute TBAD.

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