Therapeutic profile of manidipine and lercanidipine in hypertensive patients
Tóm tắt
Manidipine and lercanidipine are considered effective and safe in the treatment of chronic arterial hypertension and are equipotent in reducing blood pressure (BP) levels. Their main side effect is ankle-foot edema. After a 2-week placebo runin period, these 2 drugs were compared in a controlled parallel-group study lasting 3 months, involving 53 patients with mild-to-moderate essential hypertension (26 assigned to manidipine and 27 to lercanidipine). At the end of the active treatment period, BP was significantly reduced in comparison with the end of the placebo phase in both the manidipine and the lercanidipine groups, without significant differences between the 2 drugs. Daytime BP was significantly reduced by 5.5%/5.6% with manidipine and by 3.8%/6.6% with lercanidipine, while smaller reductions were seen at nighttime. The smoothness index was the same with both drugs. Unlike lercanidipine, manidipine significantly reduced both basal (-30%) and minimal vascular resistance (-39%), qualifying it as a potent vasodilator. Despite vasodilation, heart rate was not increased but was even slightly reduced by treatment. Ankle-foot edema was observed with both drugs but was less pronounced with manidipine, probably because of greater postcapillary dilatation. In conclusion, manidipine and lercanidipine are both effective and safe in mild-to-moderate essential hypertension, although the former seems to have a more favorable tolerability profile than the latter.
Tài liệu tham khảo
Borghi C, Prandin MG, Dormi A, Ambrosini E. Improved tolerability of the dihydropyridine calcium-channel antagonist lercanidipine: the lercanidipine challenge trial.Blood Pressure. 2003;12(suppl 1):14–21.
McClellan KJ, Jarvis B. Lercanidipine: a review of its use in hypertension.Drugs. 2000;60:1123–1140.
Arima S, Ito S, Omata K, Tsunoda K, Yaoita H, Abe K. Diverse effects of calcium antagonists on glomerular haemodynamics.Kidney Int. 1996;55(suppl):S132-S134.
Sabbatini M, Leonardi A, Testa R, Vitaioli L, Amenta F. Effect of calcium antagonists on glomerular arterioles in spontaneously hypertensive rats.Hypertension. 2000;35:775–779.
Campo C, Garcia-Vallejo O, Barrios V, et al. The natriuretic effect of nifedipine gastrointestinal therapeutic system remains despite the presence of mild-to-moderate renal failure.J Hypertens. 1997;15(12 pt 2):1803–1808.
Chou TC, Li CY, Yen MH, Ding YA. Antiplatelet effect of amlodipine: a possible mechanism through a nitric oxide-mediated process.Biochem Pharmacol. 1999;58:1657–1663.
Buhler FR. Cardiovascular care with the new T-type calcium channel antagonist: possible role of attendant sympathetic nervous system inhibition.J Hypertens Suppl. 1997;15:S3-S7.
Simon A, Levenson J. Effects of calcium channel blockers on atherosclerosis: new insights.Acta Cardiol. 2002;57:249–255.
Angelico P, Guarnieri N, Leonardi A, Testa R. Vascular-selective effect of lercanidipine and other 1,4-dihydropyridines in isolated rabbit tissues.J Pharm Pharmacol. 1999;51:709–714.
Messerli FH. Calcium antagonists in hypertension: from hemodynamics to outcomes.Am J Hypertens. 2002;15(7 pt 2):94S-97S.
Fogari R, Malamani GD, Zoppi A, et al. Comparative effect of lercanidipine and nifedipine gastrointestinal therapeutic system on ankle volume and subcutaneous interstitial pressure in hypertensive patients: a double-blind, randomized, parallel-group study.Curr Ther Res Clin Exp. 2000;61:850–862.
Lund-Johansen P, Stranden E, Helberg S, et al. Quantification of leg oedema in post-menopausal hypertensive patients treated with lercanidipine or amlodipine.J Hypertens. 2003;21:1003–1010.
Leonetti G. Tolerability of long-term treatment with lercanidipine versus amlodipine and lacidipine in elderly hypertensives.Am J Hypertens. 2002;15:932–940.
Cheer SM, McClellan K: Manidipine: a review of its use in hypertension.Drugs. 2001;61:1777–1799.
Epstein M. Lercanidipine: a novel dihydropyridine calcium-channel blocker.Heart Dis. 2001;3:398–407.
Barrios V, Navarro A, Esteras A, et al. Antihypertensive efficacy and tolerability of lercanidipine in daily clinical practice. The ELYSPE study. Eficacia de Lercanidipino y su Perfil de Seguridad.Blood Press. 2002;11:95–100.
Specchia G, Saccaggi SP, Chezzi C. Cardiovascular safety of lercanidipine in patients with angina pectoris: a review of six randomized clinical trials.Curr Ther Res Clin Exp. 2001;62:3–15.
Messerli FH. Vasodilatory edema: a common side effect of antihypertensive therapy.Curr Cardiol Rep. 2002;4:479–482.
Palatini P, Frigo G, Bertolo O, Roman E, Da Corta R, Winniki M. Validation of the A& D TM-2430 device for ambulatory blood pressure monitoring and evaluation of performance according to subjects’ characteristics.Blood Press Monit. 1998;3:255–260.
Casiglia E, Petucco S, Pessina AC. Antihypertensive efficacy of amlodipine and enalapril and effects on peripheral blood flow in patients with essential hypertension and intermittent claudication.Clin Drug Invest. 1995;11(suppl):97–101.
Sakaguchi S, Ishitobi K, Kameda T. Functional segmental plethysmography with mercury strain gauge.Angiology. 1972;23:127–135.
Eichna LW, Wilkins RW. Blood flow to the forearm and calf. Reactive hyperemia: factors influencing the blood flow during vasodilation following ischemia.Bull Johns Hopkins Hosp. 1941;68:450–456.
Muiesan ML, Rizzoni D, Zulli R, et al. Cardiovascular characteristics in normotensive subjects with or without family history of hypertension.Clin Exp Hypertens. 1996;18:901–920.
Brjiker F, Hejidra YF, Van Den Eishout FJ, Bosch FH, Folgering HT. Volumetric measurements of peripheral oedema in clinical conditions.Clin Physiol. 2000;20:56–61.
Karges JR, Mark BE, Stikeleather SJ, Worrell TW. Concurrent validity of upper-extremity volume estimates: comparison of calculated volume derived from girth measurements and water displacement volume.Phys Ther. 2003;83:134–145.
Weir MR, Rosenberger C, Fink JC. Pilot study to evaluate a water displacement technique to compare effects of diuretics and ACE inhibitors to alleviate lower extremity edema due to dihydropyridine calcium antagonists.Am J Hypertens. 2001;14:963–968.
Parati G, Omboni S, Rizzoni D, Agabiti-Rosei E, Mancia G. The smoothness index: a new, reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension.J Hypertens. 1998;16:1685–1691.
Grassi G, Serravalle G, Turri C, Bolla G, Mancia G. Shortversus long-term effects of different dihydropyridines on sympathetic and baroreflex function in hypertension.Hypertension. 2003;41:558–562.
Messerli FH, Grossman E. Pedal edema-not all dihydropyridine calcium antagonists are created equal.Am J Hypertens. 2002;15:1019–1020.
Salmasi AM, Belcaro G, Nicolaides AN. Impaired venoarteriolar reflex as a possible cause for nifedipine-induced ankle oedema.Int J Cardiol. 1991;30:303–307.
