Long-term effects of benidipine hydrochloride on severe left ventricular hypertrophy and collagen metabolism in patients with essential hypertension.
OBJECTIVE
The long-term effects of benidipine on left ventricular hypertrophy (LVH) and collagen metabolism were examined in patients with essential hypertension.


METHODS
Forty patients with untreated essential hypertension were given benidipine at a dose of 6 mg a day. Routine echocardiographic parameters, serum concentrations of matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were analyzed before and 12 months after treatment with benidipine. Patients were classified according to left ventricular mass index (LVMI) into three groups: severe LVH (LVMI > or = 159), mild LVH (159 > LVMI > or = 125) and no LVH (LVMI < 125).


RESULTS
Serum levels of free TIMP-1 to MMP-1 ratio were significantly higher in patients with severe LVH than in the other two groups before treatment. There was a significant positive correlation between the free TIMP-1 to MMP-1 ratio and LVMI in all study subjects (r = 0.51, p < 0.01). Twelve months after treatment, percentage changes of the LVMI and free TIMP-1 to MMP-1 ratio were significantly larger in the patients with severe LVH (-27% and -54%) than with mild LVH (-12% and -23%) or no LVH (-4% and -11%), respectively. Changes in the systolic blood pressure but not changes in the free TIMP-1 to MMP-1 ratio correlated with changes in the LVMI in patients with mild LVH (r = 0.78, p < 0.01). Changes in the free TIMP-1 to MMP-1 ratio but not changes in the systolic blood pressure correlated with changes in the LVMI in patients with severe LVH (r = 0.69, p < 0.01).


CONCLUSIONS
Long-term administration of benidipine reduced left ventricular mass and normalized systemic collagen type I degradation abnormalities in essential hypertensive patients with severe but not mild LVH.
Hirono
Osamu
O
First Department of Internal Medicine, Yamagata University School of Medicine, Iida-Nishi 2-2-2, Yamagata, Yamagata 990-9585.
Fatema
Kaniz
K
Nitobe
Joji
J
Takeishi
Yasuchika
Y
Kaneko
Kazuyoshi
K
Shiga
Ryoko
R
Kubota
Isao
I
D000284:Administration, Oral; D000368:Aged; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000627:therapeutic use; D003094:Collagen / Q000378:metabolism*; D004095:Dihydropyridines / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000378:metabolism*; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000097:blood; D008875:Middle Aged; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D019715:Tissue Inhibitor of Metalloproteinase-1; C061004:benidipine; D003094:Collagen; D020781:Matrix Metalloproteinase 1