Therapeutic profile of manidipine and lercanidipine in hypertensive patients.
Manidipine and lercanidipine are considered effective and safe in the treatment of chronic arterial hypertension and are equipotent in reducing blood pressure (BP) levels. Their main side effect is ankle-foot edema. After a 2-week placebo run-in period, these 2 drugs were compared in a controlled parallel-group study lasting 3 months, involving 53 patients with mild-to-moderate essential hypertension (26 assigned to manidipine and 27 to lercanidipine). At the end of the active treatment period, BP was significantly reduced in comparison with the end of the placebo phase in both the manidipine and the lercanidipine groups, without significant differences between the 2 drugs. Daytime BP was significantly reduced by 5.5%/5.6% with manidipine and by 3.8%/6.6% with lercanidipine, while smaller reductions were seen at nighttime. The smoothness index was the same with both drugs. Unlike lercanidipine, manidipine significantly reduced both basal (-30%) and minimal vascular resistance (-39%), qualifying it as a potent vasodilator. Despite vasodilation, heart rate was not increased but was even slightly reduced by treatment. Ankle-foot edema was observed with both drugs but was less pronounced with manidipine, probably because of greater postcapillary dilatation. In conclusion, manidipine and lercanidipine are both effective and safe in mild-to-moderate essential hypertension, although the former seems to have a more favorable tolerability profile than the latter.
Casiglia
Edoardo
E
Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Mazza
Alberto
A
Tikhonoff
Valérie
V
Basso
Giancarlo
G
Martini
Bortolo
B
Scarpa
Roberta
R
Pessina
Achille Cesare
AC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002121:Calcium Channel Blockers / Q000009:adverse effects* / Q000627:therapeutic use; D004095:Dihydropyridines / Q000009:adverse effects* / Q000627:therapeutic use; D004487:Edema / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005528:Foot / Q000098:blood supply; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009578:Nitrobenzenes; D010879:Piperazines; D010991:Plethysmography
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D009578:Nitrobenzenes; D010879:Piperazines; C054218:manidipine; C060343:lercanidipine