Antihypertensive efficiency and safety of L - & N-type Ca^(2+) antagonists -cilnidipine

Objectives To evaluate antihypertensive efficiency and safety of a new domesticof L - & N - type Ca2+ antagonist - cilnidipine with imidapril as a positive control. Methods After 2 weeks' placebo washingout, 22 patients were treated with cilnidipine 5 mg daily and 27 patients were treated with imidapril 5 mg daily. 4 weeks later, if patient's sitting diastolic blood pressure is over 90 mmHg, his/ her dosage was doubled for another 4 weeks, the others measuring up remained their dosage unchanged for another 4 weeks. Blood pressure, heart rate, blood and urine routine examination, serum glucose, serum chemical examination including total cholesterol, triglyceride. HDL, LDL, transaminase, creatine etc and side reactions were recorded before and after the trial. Data were analyzed statistically. Results After 8 weeks' treatment, blood pressure was significantly decreased ( P < 0. 05) in both groups, and the two medicines had similar antihypertensive effects. Furthermore, the reducing of heart rate was statistically significant compared with baseline ( P < 0. 01) in the cilnidipine group, but not in the imidapril group. The negative chronotropic effect of cilnidipine had little effect on continuing the therapy. There were no changes on blood and urine routine examination and serum lipid, serum glucose, creatine, transaminase and etc in both groups. Their side reactions were mild and well- tolerated. Conclusions Cilnidipine has a convincing antihypertensive effect similar to that of imidapril. Especially cilnidipine may be administered to patients with relatively mild tachycardia.

Effects of cilnidipine and L-type calcium channel blockers on renal functions in hypertensive patients: a meta-analysis of the randomized trials

In the present study, we aimed to evaluate the effects of cilnidipine and L-type calcium channel blockers（L-type CCBs） on renal function in hypertensive patients. The randomized controlled trials（RCTs） of cilnidipine and L-type CCBs on hypertension treatment were selected from Pubmed, Embase, Google Scholar, CNKI, Science Direct, Ebsco, Springer, Ovid, Cochrane Library, Medline, VIP and Wanfang databases（from the date of databases＇ establishment to September 2014）. Data were independently evaluated following the Jadad standard. The percentage changes of serum creatinine（SCr） value, urinary protein excretion（UPE）, urinary protein/creatinine ratio（UPCR） and estimated glomerular filtration rate（e GFR） pre- and post-treatment were extracted for the subsequent meta-analysis. The mean difference（MD） and the 95% confidence interval（95% CI） were determined using RevM an 5.3 software. A total of 10 RCTs of high quality were included and analyzed by fixedor random-effect models. The results indicated that UPE（MD = –36.59, 95% CI： –70.85, –2.33） or UPCR（MD = –46.56, 95% CI： –88.50, –4.62） was significantly reduced by cilnidipine compared with L-type CCBs. However, such significant difference was not detected in reduction of SCr（MD = 0.01, 95% CI： –2.97, 2.98） or eG FR（MD = 1.56, 95% CI： –0.19, 3.31）. Compared with L-type CCBs, cilnidipine was more effective in reducing proteinuria or preventing the proteinuria progression. In addition, we did not find significant differences in SCr and eG FR between the two groups.