Effect of cilnidipine on normal to marginally elevated urine albumin-creatinine ratio in asymptomatic non-diabetic hypertensive patients: an exponential decay curve analysis.
BACKGROUND
High-normal urinary albumin excretion has been reported to have clinical significance with respect to progression of proteinuria and hypertension.


OBJECTIVE
We analysed the effect of cilnidipine (10 mg/day) on morning systolic blood pressure (SBP) and urine albumin-creatinine ratio (UACR) in 16 non-diabetic hypertensive patients with a normal to marginally elevated UACR (mean +/- SD 29.4 +/- 21.7; range 7.5-72.9 mg/g creatinine).


METHODS
Sequential home BP and UACR data were fitted to a simple exponential function as follows: where y is SBP (mmHg) or UACR (mg/g creatinine); alpha is the extent of the SBP (mmHg)- or UACR (mg/g creatinine)-lowering effect; beta (days) is the time-constant for SBP or UACR decrease; t is the number of days after the start of cilnidipine administration; and gamma is the finally stabilized SBP (mmHg) or UACR (mg/g creatinine).


RESULTS
Mean +/- SD morning SBP and UACR decreased by 20.4 +/- 11.4 mmHg and 15.2 +/- 13.1 mg/g creatinine, respectively, as determined by coefficient alpha. The mean +/- SD time-constant for UACR decrease was significantly longer than that for BP decrease (43.5 +/- 22.9 vs 15.4 +/- 7.1 days). UACR reduction correlated with pre-treatment UACR values (correlation coefficient [R] = 0.88, p < 0.01) but not with BP decrease.


CONCLUSIONS
The present study demonstrated that cilnidipine reduced UACR in hypertensive patients with normal to marginally elevated UACR independent of its BP-lowering effect.
Nakatsu
Takaaki
T
Department of Cardiology, Kagawa-ken Saiseikai Hospital, Takamatsu, Japan.
Toyonaga
Shinji
S
Mashima
Keiichi
K
Yuki
Yoko
Y
Nishitani
Aya
A
Ogawa
Hiroko
H
Miyoshi
Toru
T
Hirohata
Satoshi
S
Izumi
Reishi
R
Kusachi
Shozo
S
D000419:Albuminuria / Q000188:drug therapy* / Q000209:etiology / Q000652:urine; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D003404:Creatinine / Q000652:urine*; D004095:Dihydropyridines / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D015233:Models, Statistical; D009391:Nephelometry and Turbidimetry; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D015415:Biomarkers; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C065927:cilnidipine; D003404:Creatinine