title: Long-term effects of L- and N-type calcium channel blocker on uric acid levels and left atrial volume in hypertensive patients.
abstract: Left ventricular (LV) diastolic dysfunction is associated with hypertension and hyperuricemia. However, it is not clear whether the L- and N-type calcium channel blocker will improve LV diastolic dysfunction through the reduction of uric acid. The aim of this study was to investigate the effects of anti-hypertensive therapy, the L- and N-type calcium channel blocker, cilnidipine or the L-type calcium channel blocker, amlodipine, on left atrial reverse remodeling and uric acid in hypertensive patients. We studied 62 patients with untreated hypertension, randomly assigned to cilnidipine or amlodipine for 48 weeks. LV diastolic function was assessed with the left atrial volume index (LAVI), mitral early diastolic wave (E), tissue Doppler early diastolic velocity (E') and the ratio (E/E'). Serum uric acid levels were measured before and after treatment. After treatment, systolic and diastolic blood pressures equally dropped in both groups. LAVI, E/E', heart rate and uric acid levels decreased at 48 weeks in the cilnidipine group but not in the amlodipine group. The % change from baseline to 48 weeks in LAVI, E wave, E/E' and uric acid levels were significantly lower in the cilnidipine group than in the amlodipine group. Larger %-drop in uric acid levels were associated with larger %-reduction of LAVI (p < 0.01). L- and N-type calcium channel blocker but not L-type calcium channel blocker may improve LV diastolic function in hypertensive patients, at least partially through the decrease in uric acid levels.
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.|Division of Clinical Laboratory Medicine, Hyogo College of Medicine, Nishinomiya, Japan.|Center for Health Evaluation and Promotion, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Masaki
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan. mano@hyo-med.ac.jp.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Mano
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.|Division of Clinical Laboratory Medicine, Hyogo College of Medicine, Nishinomiya, Japan.|Center for Health Evaluation and Promotion, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
authors.forename: Akiyo
authors.initials: A
authors.lastname: Eguchi
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Fujiwara
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Sugahara
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hirotani
authors.affiliation: Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.|Osaka Clinic, Takeda Pharmaceutical Company Limited, Osaka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Komamura
authors.affiliation: Division of Clinical Laboratory Medicine, Hyogo College of Medicine, Nishinomiya, Japan.|Center for Health Evaluation and Promotion, Hyogo College of Medicine Hospital, Nishinomiya, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Koshiba
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use*; D016279:Atrial Function, Left / Q000187:drug effects*; D064752:Atrial Remodeling / Q000187:drug effects*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D020746:Calcium Channels, L-Type / Q000187:drug effects*; D020864:Calcium Channels, N-Type / Q000187:drug effects*; D002681:China; D003971:Diastole; D004095:Dihydropyridines / Q000627:therapeutic use*; D015536:Down-Regulation; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D033461:Hyperuricemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D015415:Biomarkers; D002121:Calcium Channel Blockers; D020746:Calcium Channels, L-Type; D020864:Calcium Channels, N-Type; D004095:Dihydropyridines; D017311:Amlodipine; D014527:Uric Acid; C065927:cilnidipine
keywords: Diastolic dysfunction; Hypertension; L- and N-type calcium channel blocking drugs; Uric acid
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