Effects of Benidipine, a Long-Acting T-Type Calcium Channel Blocker, on Home Blood Pressure and Renal Function in Patients with Essential Hypertension

Abstract

These results demonstrate that benidipine favourably affects renal function in patients with essential hypertension compared with amlodipine, suggesting that the clinical benefits of benidipine as an antihypertensive drug include a renoprotective effect.

Differential effect of T-type voltage-gated Ca2+ channel disruption on renal plasma flow and glomerular filtration rate in vivo

“…Combined T-and L-type blockers have been suggested to have a therapeutic advantage over selective L-type blockers by providing renoprotection due to differential expression of Ca 2ϩ channels, with only T-type Ca 2ϩ channels (Ca v 3.1 and Ca v 3.2) expressed in efferent arterioles (15,22,42). Clinical data support a renoprotective effect of combined T-and L-type blockers as it was concluded that treatment with a combined L-and T-type antagonist yields greater efficacy that a L-type antagonist in reducing blood pressure and proteinuria (32,33,38). The Amlodipine-to-Benidipine Changeover study showed that benidipine (a combined L-and T-type antagonist) caused a larger reduction in blood pressure and proteinuria compared with L-type treatment by amlodipine (32), suggesting a vasoconstrictor effect of T-type Ca 2ϩ channels on efferent arterioles.…”

Functional Importance of L- and P/Q-Type Voltage-Gated Calcium Channels in Human Renal Vasculature

“…16 -18 In a crossover study, benidipine (L-and T-type antagonist) caused a larger reduction in blood pressure and proteinuria compared with L-type treatment using amlodipine, 16 and benidipine favorably affects renal function in patients with essential hypertension compared with amlodipine. 18 These studies suggest a clinical benefit of benidipine over amlodipine as an antihypertensive drug because of a renoprotective effect. The observation of superior renoprotective effects with a combined L-and T-type treatment is in agreement with the previous demonstration of a differential expression of calcium channels in rodent kidney with a vasoconstrictor effect of T-type channels on efferent arterioles.…”

Functional importance of T-type voltage-gated calcium channels in the cardiovascular and renal system: news from the world of knockout mice

“…In clinical studies, T-type channel blockers decrease blood pressure to a lower extent than L-type blockers (76,77,89). The effect of L-and T-type calcium blockers on hypertension was investigated in a changeover (ABC) study in 58 hypertensive patients.…”

“…T-type blockers could be an additional tool for treating hypertensive proteinuric kidney disease (32). The T-type antagonist efonidipine slows the progression of proteinuric kidney disease in a manner similar to angiotensin-converting enzyme inhibitors (39), and proteinuria treatment with a combination of L-and T-type antagonists yields greater efficacy than the L-type antagonist alone (76,77,89). Furthermore, Sugano et al (99) have shown in subtotally nephrectomized rats that the specific T-type antagonist R(-)-efonidipine significantly reduced proteinuria and tubulointerstitial fibrosis.…”

“…T-type channels are also suggested to play a role in pacemaker activity and in atrioventricular conduction (31,66,68). Interestingly, clinical studies using combined L-and T-type blockers have shown a beneficial effect on high blood pressure, proteinuria, arterial stiffness, and endothelial dysfunction compared with selective L-type blockers (53,76,77,79,89). The challenge in all of these studies is the lack of selective T-type blockers.…”