Plasma renin activity and aldosterone concentration are not altered by the novel calcium channel antagonist, azelnidipine, in hypertensive patients.
OBJECTIVE
In hypertensive patients, primary aldosteronism (PA) is the most prevalent type of secondary hypertension, and screening for PA has become very important. Calcium channel blockers (CCB) are widely used to treat hypertension, but most CCBs stimulate plasma renin activity (PRA) and increase plasma aldosterone concentration (PAC), both of which are used in the screening for PA. The aim of this study was to determine whether the newly introduced CCB, azelnidipine, affects PRA and PAC.


METHODS
40 hypertensive patients were treated with 16 mg of azelnidipine for 4 weeks.


RESULTS
Azelnidipine treatment in drug-naïve (DN) cases significantly decreased systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR). PRA and PAC in the DN group on azelnidipine treatment were indistinguishable from those in the DN group before treatment. Compared with other CCB treatments such as amlodipine, manidipine and slow-release nifedipine, azelnidipine showed comparable or significant reductions in SBP, DBP and HR. In patients who were switched from other CCBs to azelnidipine, PRA and PAC were decreased, except for PAC on amlodipine treatment. Since the PRA reduction rate exceeded that of PAC, the aldosterone/renin ratio (ARR) was significantly increased in those on azelnidipine treatment who had been switched from manidipine or nifedipine treatment, suggesting the restoration of possibly underestimated ARR values.


CONCLUSIONS
These data indicate that azelnidipine does not affect PRA or PAC, suggesting that azelnidipine could be a useful antihypertensive CCB while undergoing PA screening.
Kondo
Tatsuya
T
Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto.
Goto
Rieko
R
Sonoda
Kazuhiro
K
Yasuda
Takeomi
T
Ono
Kaoru
K
Takaki
Yuki
Y
Yatsuda
Riichiro
R
Miyamura
Nobuhiro
N
Araki
Eiichi
E
D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood*; D001383:Azetidinecarboxylic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D000450:Aldosterone; D001383:Azetidinecarboxylic Acid; D012083:Renin; C061679:azelnidipine