Antihypertensive Efficacy and Safety of Manidipine versus Amlodipine in Elderly Subjects with Isolated Systolic Hypertension

Payeras, Antonio Coca; Sładek, Krzysztof; Lembo, Giuseppe; Alberici, Marco

doi:10.2165/00044011-200727090-00004

Cited by 9 publications

(2 citation statements)

References 30 publications

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“…Chlortalidone 25 mg once daily could be added if BP remained uncontrolled despite treatment with the high dose of manidipine or amlodipine. After 12 weeks of treatment, similar reductions of systolic BP were observed in both groups (−19.5 and −18.4 mmHg, respectively; p =NS) [ 79 ]. In a meta-analysis that included 4 head-to-head randomized and controlled clinical trials of at least 12 months of treatment comparing the antihypertensive efficacy and safety of manidipine 20 mg with that of amlodipine 10 mg, a total of 838 patients were analyzed (436 in the manidipine group and 402 in the amlodipine group).…”

Section: Manidipine: Beneficial Effects Beyond Blood Pressure Controlmentioning

confidence: 79%

Manidipine: an antihypertensive drug with positive effects on metabolic parameters and adrenergic tone in patients with diabetes

Saiz-Satjes

Martínez-Martín

2018

DIC

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Antihypertensive treatment of patients with diabetes should include those drugs with a positive effect on metabolic parameters. Most patients with diabetes require at least two antihypertensive agents. Combining a dihydropyridine calcium channel blocker with a renin-angiotensin-aldosterone system inhibitor is a rational approach. However, not all dihydropyridines are equal with respect to their effects on metabolic parameters. Thus, manidipine exerts a positive effect on insulin resistance. However, this effect has not been observed with amlodipine. On the other hand, the excessive activation of sympathetic nervous system has been related with an increase of insulin resistance, pulse pressure, and ankle edema rates. Compared with amlodipine, manidipine activates sympathetic nervous system to a lesser extent. As a result, treatment with manidipine represents a good option in hypertensive patients with diabetes.

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Section: Manidipine: Beneficial Effects Beyond Blood Pressure Controlmentioning

confidence: 79%

Manidipine: an antihypertensive drug with positive effects on metabolic parameters and adrenergic tone in patients with diabetes

Saiz-Satjes

Martínez-Martín

2018

DIC

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“… 1 , 7 , 24 , 25 Furthermore, the recent National Institute of Clinical Excellence (NICE) guidelines recommend calcium channel blockers as the first-line agent of choice in all patients aged 55 years or older or of African descent (Figure 1 ). Amlodipine has been shown to be an effective well-tolerated antihypertensive agent in older patients, 26 – 28 and its efficacy is not affected by age. 26 …”

Section: Introductionmentioning

confidence: 99%

Incremental Blood Pressure–Lowering Effect of Titrating Amlodipine for the Treatment of Hypertension in Patients Including Those Aged ≥55 Years

Jeffers¹,

Bhambri²,

Robbins³

2015

American Journal of Therapeutics

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Small reductions in blood pressure reduce the risk of cardiovascular events. Here, we report 2 post hoc pooled analyses assessing the antihypertensive effect of amlodipine in patients who had not responded to 5 mg and were uptitrated to 10 mg. The first analysis assessed subgroups of patients aged either younger than 55 years or 55 years or older and the second analysis pooled all patients irrespective of age. Of 706 patients in the age-related analysis, a statistically significant decrease in blood pressure from baseline was observed {for younger than 55 years [N = 253]: systolic blood pressure = −12.8 [standard error (SE) = 0.90] mm Hg, diastolic blood pressure = −8.0 [SE = 0.55] mm Hg; for 55 years or older [N = 453]: systolic blood pressure = −12.1 [SE = 0.66] mm Hg, diastolic blood pressure = −6.7 [SE = 0.39] mm Hg; all P < 0.0001}. In total, 45.8% and 39.3% of patients aged younger than 55 and 55 years or older, respectively, achieved their blood pressure goals. Adverse events were experienced by 62 (24.5%) patients aged younger than 55 years and 136 (30.0%) patients aged 55 years or older. Similar efficacy and safety results were seen in the all patient pooled analysis. Titration of amlodipine from 5 mg to 10 mg significantly decreased blood pressure in older hypertensive patients, which is clinically relevant because increased age is associated with hypertension and cardiovascular events.

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Changes of action potential and L-type calcium channel current of Sprague–Dawley rat ventricular myocytes by different amlodipine isomers

Wang

Jiang

2008

Can. J. Physiol. Pharmacol.

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To investigate the effects of S- and R-amlodipine (Aml) on action potential (AP) and L-type calcium channel current (ICa-L), the whole-cell patch-clamp technique was used on rat ventricular myocytes to record AP, ICa-L, peak currents, steady-state activation currents, steady-state inactivation currents, and recovery currents from inactivation with S-Aml and R-Aml at various concentrations. Increasing concentrations of S-Aml gradually shortened AP durations (APDs). At concentrations of 0.1, 0.5, 1, 5, and 10 micromol/L, S-Aml blocked 1.5% +/- 0.2%, 25.4% +/- 5.3%, 65.2% +/- 7.3%, 78.4% +/- 8.1%, and 94.2% +/- 5.0% of ICa-L, respectively (p < 0.05), and the half-inhibited concentration was 0.62 +/- 0.12 micromol/L. Current-voltage curves were shifted upward; steady-state activation and inactivation curves were shifted to the left. At these concentrations of S-Aml, the half-activation voltages were -16.01 +/- 1.65, -17.61 +/- 1.60, -20.17 +/- 1.46, -21.87 +/- 1.69, and -24.09 +/- 1.87 mV, respectively, and the slope factors were increased (p < 0.05). The half-inactivation voltages were -27.16 +/- 4.48, -28.69 +/- 4.52, -31.19 +/- 4.17, -32.63 +/- 4.34, and -35.16 +/- 4.46 mV, respectively, and the slope factors were increased (p < 0.05). The recovery times from inactivation of S-Aml were prolonged (p < 0.05). In contrast, R-Aml had no effect on AP and ICa-L (p > 0.05) at the concentrations tested. Thus, only S-Aml has calcium channel blockade activity, whereas R-Aml has none of the pharmacologic actions associated with calcium channel blockers.

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Antihypertensive Efficacy and Safety of Manidipine versus Amlodipine in Elderly Subjects with Isolated Systolic Hypertension

Abstract: In elderly patients with ISH, treatment with manidipine for 12 weeks was well tolerated and effective and the antihypertensive effects obtained with manidipine were the same as those obtained with amlodipine.

Cited by 9 publications

References 30 publications

Manidipine: an antihypertensive drug with positive effects on metabolic parameters and adrenergic tone in patients with diabetes

Manidipine: an antihypertensive drug with positive effects on metabolic parameters and adrenergic tone in patients with diabetes

Incremental Blood Pressure–Lowering Effect of Titrating Amlodipine for the Treatment of Hypertension in Patients Including Those Aged ≥55 Years

Changes of action potential and L-type calcium channel current of Sprague–Dawley rat ventricular myocytes by different amlodipine isomers

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