Background: Hypertension is a widespread public health problem and a major risk factor. Amlodipine, a calcium channel blocker is frequently used in the treatment of hypertension. Since Amlodipine primarily L-type calcium channel blocker (CCB) and thus reduces blood pressure, it stimulates sympathetic nerve activity leading to reflex increase in heart rate. Cilnidipine, a new type of CCB which can inhibit L- type calcium channels but also N-type calcium channels. We compare the clinical effectiveness of Amlodipine and Cilnidipine on blood pressure, heart rate, proteinuria and lipid profile in hypertensive patients. Methods: The study was a prospective, randomized, open label comparison, total ninety five patients were recruited for study in which 45 patients received 5-10mg Amlodipine and other 55 patients of same age groups received 10-20mg Cilnidipine. 15 patients in Amlodipine group and 18 patients in Cilnidipine group were diabetic, whereas 12 and 14 patients were proteinuric in Amlodipine and Cilnidipine group respectively. Results: Both the groups were well matched in term of age, weight, clinical findings and laboratory values. Both the drug significantly reduced both systolic (SBP) and diastolic blood pressure (DSP). In the Amlodipine group the pulse rate (PR) after treatment tended to be higher than those before treatment. In the Cilnidipine group there was decrease in PR after treatment. Unlike Amlodipine, Cilnidipine decreased urinary protein excretion and in diabetic patients reduced serum triglyceride. Conclusions: The study indicates that unlike Amlodipine, Cilnidipine which inhibits L-and N-type calcium channels will be useful for patients with hypertension and cardiovascular disease, diabetes mellitus or renal disease and proves to be a better alternative to existing calcium channel blockers. [Int J Basic Clin Pharmacol 2013; 2(2.000): 160-164

INTRODUCTIONHypertension is a common disorder in adults around the globe and among the most common attributable causes of mortality.1 The goal of antihypertensive therapy is to maintain blood pressure of <140/90mmHg for most people. [2][3][4][5][6][7] The angiotensin receptor blockers (ARBs) have been in clinical use since 1995 and known to be effective antihypertensive agent with excellent tolerability profiles. Azilsartan medoximil, a new generation ARB for the treatment of essential hypertension. Azilsartan was discovered through the efforts of scientists from Takeda, a Japanese pharmaceutical company by modifying the tetrazole ring present in candesartan. The chemical structure of azilsartan is very similar to the structure of candesartan and differs only by replacement of candesartan's 5 member tetrazole ring with the oxaoxadiazole ring of azilsartan. This modification makes azilsartan less acidic and more lipophilic than candesartan. Azilsartan was recently approved and has been shown to provide a more potent and sustained antihypertensive effects than other ARBs. Azilsartan medoxomil, ABSTRACT Background: Hypertension has been identified as the leading risk factor for mortality worldwide. It may lead to damage of heart, kidney, brain, vasculature and the other organs results in premature morbidity and death. The angiotensin receptor blockers are effective antihypertensive agent with excellent tolerability profiles. Azilsartan medoximil is a new ARB recently approved for treatment of hypertension. The objective of the study was to compare efficacy and tolerability of once daily treatment of the new angiotensin type1 receptor blocker (ARB) Azilsartan with Olmesartan and Candesartan. Methods: The study was a prospective, randomized open label comparison. Total 411 patients were recruited for the study. Patients were divided into four groups. Group A comprising of 105 patients received azilsartan (40mg), Group B comprising of 106 patients received azilsartan (80mg), Group C comprising of 102 patients received olmesartan (40mg) and Group D comprising of 98 patients received candesartan (12mg). Blood pressure was monitored at base line, after 2 weeks, 4 weeks and 8 weeks of treatment. Results: All groups were well matched in terms of age, weight, clinical findings and laboratory values. All drugs reduced both systolic blood pressure (SBP) and Diastolic blood pressure (DSP) significantly, but the reduction in SBP and DSP with azilsartan (80mg) was significantly greater than other drugs. The difference in BP reduction between azilsartan (40mg) and olmesartan (40mg) were not significant but both azilsartan (40mg) and olmesartan (40mg) were significantly more effective than candesartan(12mg). Conclusions: The study indicates that azilsartan (80mg) is more effective in the control of hypertension than olmesartan and candesartan with similar safety profile.