title: Effects of the L/N-type calcium channel antagonist cilnidipine on morning blood pressure control and peripheral edema formation.
abstract: The L/N-type calcium channel blocker cilnidipine has unique effects including sympathetic nerve suppression and the balanced vasodilatation of arteries and veins that may alleviate morning hypertension (MHT) or peripheral edema caused by calcium channel antagonists. We used ambulatory blood pressure monitoring (ABPM) and a unique peripheral edema measurement to evaluate the effect of morning and bedtime cilnidipine in patients with MHT. Forty-three patients with MHT (60 ± 12 years) were randomly assigned to a morning or bedtime cilnidipine (10-20 mg/day). MHT was defined as a mean systolic blood pressure (SBP) ≥ 135 mm Hg by ABPM within 2 hours after awaking. After 3 months, greater SBP reductions were observed in the bedtime administration group (versus the morning administration group) at 3:30-6:00 AM (-24 ± 20 mm Hg vs. -10 ± 4 mm Hg; P < .05) and at 6:30-9:00 AM (-26 ± 15 mm Hg vs. -14 ± 17 mm Hg; P < .05). Although physical examinations showed leg edema in 16% of the patients, quantitative evaluations did not reveal significant volume gains. Cilnidipine had a greater effect on MHT, without causing significant leg edema, when administered at bedtime.
authors.affiliation: Division of Cardiology, Saiseikai Futsukaichi Hospital, Chikushino, Japan.
authors.forename: Sumito
authors.initials: S
authors.lastname: Narita
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Atsumi
authors.initials: A
authors.lastname: Ide
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kadokami
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Momii
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Ando
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D004095:Dihydropyridines / Q000494:pharmacology*; D004487:Edema / Q000517:prevention & control*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000517:prevention & control; D007866:Leg; D008297:Male; D008875:Middle Aged; D013564:Sympathetic Nervous System / Q000503:physiopathology
chemical_list: D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C065927:cilnidipine