title: Azelnidipine and glucose tolerance: possible indications and treatment selection for hypertensive patients with metabolic disorders.
abstract: Azelnidipine is a unique dihydropyridine calcium channel blocker with selectivity for L-type calcium channels that has been launched for the treatment of hypertension. Azelnidipine exhibits long-acting blood pressure-lowering effects without increasing heart rate. High blood pressure is associated with many metabolic disorders, including glucose intolerance and insulin resistance. Antihypertensive medications that interfere with various steps in the renin-angiotensin system improve glucose tolerance and insulin resistance; however, the effects of calcium channel blockers on glucose metabolism and insulin resistance remain controversial. Recent studies have demonstrated that azelnidipine could improve insulin resistance and glucose tolerance by potentially inhibiting sympathetic nerve activity. In addition, azelnidipine exhibits anti-inflammatory and anti-oxidative effects, suggesting that it is a beneficial antihypertensive agent with anti-atherogenic and cardioprotective effects for the treatment of not only hypertensive patients with glucose intolerance, but also those with metabolic disorders.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Shimada
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D001383:Azetidinecarboxylic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000627:therapeutic use*; D018149:Glucose Intolerance / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008659:Metabolic Diseases / Q000150:complications / Q000188:drug therapy*; D012084:Renin-Angiotensin System / Q000187:drug effects*
chemical_list: D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D001383:Azetidinecarboxylic Acid; C061679:azelnidipine
keywords: anti-atherogenic effect; anti-inflammatory effect; anti-oxidative effect; azelnidipine; cardiovascular and metabolic disorders; essential hypertension; glucose tolerance; insulin resistance