Effects of Cilnidipine on Serum Uric Acid Level and Urinary Nitrogen Monoxide Excretion in Patients with Hypertension

Abstract

The effects of cilnidipine on the serum uric acid level and urinary NO excretion in hypertensive patients were investigated. Blood and urine samples of 16 hypertensive outpatients were collected before and 2 months after cilnidipine therapy (10 mg). The serum uric acid level decreased significantly after cilnidipine treatment, while the uric acid-creatinine clearance ratio was unaffected. The cilnidipine medication produced a significant increase in urinary NO excretion, although amlodipine did not change it significantly. Therefore, cilnidipine has a profound antihypertensive effect and may reduce the serum uric acid level and increase NO production in the kidney.

Lowering and Raising Serum Urate Levels: Off-Label Effects of Commonly Used Medications

“…[46][47][48] In one human study, cilnidipine induced significant reduction in blood pressure and sU level from a mean AE SD at baseline of 5.6AE0.3 mg/dL to 5.1AE0.2 mg/dL (P<.01). 49 Perhaps consistent with a urate-lowering effect, studies also indicate that CCBs may decrease the risk of gout. 50,51 Compared with no use of CCBs, CCB use was found to be associated with a 0.87 (95% CI, 0.82 to 0.93) relative risk for incident gout in patients with hypertension after adjusting for age, sex, and use of other antihypertensive drugs.…”

Effects of Cilnidipine on Heart Rate and Uric Acid Metabolism in Patients With Essential Hypertension

“…2 ). Studies by Hamada et al reported significant decrease in the SUA level and increased urinary nitrogen monoxide synthesis in hypertensive patients after treatment with cilnidipine [ 20 ]. Improvement of uric acid metabolism in hypertensive patients with CKD receiving cilnidipine has been observed in study by Uchida et al [ 7 ].…”

Effects on Uric Acid Metabolism of the Drugs except the Antihyperuricemics

“…Neither serum uric acid nor clearance and fractional excretion of uric acid changed significantly during 10-day treatment with nifedipine [43], while recent evidence suggested nifedipine has been found to reduce serum uric acid levels compared with a placebo in the A Coronary Disease Trial Investigating Outcome with Nifedipine GITS (ACTION) trial [44]. Furthermore, it has been suggested that amlodipine and cilnidipine might reduce serum uric acid level [45,46]. Captopril and enalapril increased uric acid excretion, and captopril significantly reduced serum uric acid in hypertensive patients with hyperuricemia [47], while it has been reported that ACEinhibitors have not been associated with lower serum uric levels [48,49].…”