Efficacy of Azelnidipine on Home Blood Pressure and Pulse Rate in Patients with Essential Hypertension: Comparison with Amlodipine

Yamagishi, Toshio

doi:10.1291/hypres.29.767

Cited by 21 publications

(16 citation statements)

References 18 publications

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“…in contrast to atenolol, ccBs generally increase Hr by sympathetic nerve activation due to a rapid decrease in BP. our results were consistent with previous reports, which indicate that the ccB used in this study, azelnidipine, suppresses Hr (26). in keeping with the activity of ccBs, azelnidipine has been reported to suppress the increase in Hr by the activation of sympathetic nerve activity induced by a rapid decrease in BP (27).…”

Section: Bsupporting

confidence: 94%

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Tomita¹

2009

Mol Med Rep

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Abstract. For hypertension, combination therapies are recommended to acheive a low target blood pressure. in this study, the efficacy of combination therapies for preventing organ damage was investigated in spontaneously hypertensive rats (SHr). Twenty-week-old male SHr were orally administered olmesartan (Olm) (5 mg/kg/day) for the first 4 weeks. Subsequently, rats were randomly divided into 5 groups and administered add-on drugs for another 4 weeks as follows: olm+olm (5 mg/kg/day), olm+azelnidipine (aze) (30 mg/kg/ day), olm+temocapril (Tem) (10 mg/kg/day), olm+atenolol (ate) (5 mg/kg/day), olm+hydrochlorothiazide (HcTZ) (5 mg/kg/ day). Blood pressure and heart rate were measured at weeks 0, 4 and 8 by the tail-cuff method. Heart and kidney weights were determined, and endothelial function was assessed by evaluating the dilator response to acetylcholine. in comparison to untreated control SHR, a significant reduction in systolic blood pressure was observed at weeks 4 and 8 in all groups (p<0.05), while heart rate was significantly reduced at week 8 in only the olm+aze and olm+ate groups (p<0.05). in all groups, heart but not kidney weight was significantly decreased (p<0.05), and endothelial function was significantly improved (p<0.05) compared to the control SHr. in the olm+olm, olm+Tem and olm+aze groups, endothelial function was significantly improved as compared to the other treatment groups (p<0.05). Thus, when using an angiotensin receptor blocker as a first-line therapy, an antihypertensive in the form of an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or calcium channel blocker, such as azelnidipine, should be used as a second-line drug to protect against vascular damage.

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Section: Bsupporting

confidence: 94%

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Tomita¹

2009

Mol Med Rep

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“…In a head-to-head, comparative, randomized double-blind study of azelnidipine and amlodipine in hypertensive patients, azelnidipine slightly decreased HR but amlodipine significantly increased HR, although both drugs produced an equivalent BP-lowering effect over 24 hours. 9 Slight reduction in HR with azelnidipine has been observed in other clinical studies as well, 10,11 suggesting that the HR reduction by azelnidipine is not a contingent finding.…”

Section: Introductionmentioning

confidence: 73%

Chronotropic Effects of Azelnidipine, a Slow- and Long-acting Dihydropyridine-type Calcium Channel Blocker, in Anesthetized Dogs: A Comparison With Amlodipine

Fujisawa¹,

Yorikane²,

Chiba³

et al. 2009

Journal of Cardiovascular Pharmacology

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Azelnidipine, a dihydropyridine calcium channel blocker unlike other dihydropyridine calcium channel blockers, does not increase but slightly decreases heart rate (HR) in clinical settings. In the present study, the mechanism for the HR-lowering action characteristic of azelnidipine was investigated in anesthetized dogs. In the in situ perfused sinus node preparation, the negative chronotropic action of azelnidipine was almost 5 times more potent than that of amlodipine. When injected intravenously in intact anesthetized dogs, both drugs produced a long-lasting blood pressure reduction, but the action of azelnidipine developed more slowly than that of amlodipine. Azelnidipine hardly affected HR at lower doses and decreased HR at higher doses. On the other hand, amlodipine consistently induced slight tachycardia. The HR-lowering effect of azelnidipine in autonomically blocked dogs was not much different from that in intact dogs, whereas tachycardia induced by amlodipine was eliminated in autonomically blocked dogs. However, neither drug affected the HR gain of baroreceptor reflex induced by changing carotid sinus pressure. These results suggest that compared with amlodipine, azelnidipine has a greater intrinsic negative chronotropic action and induces a lower level of reflex tachycardia most probably due to a slower development of blood pressure-lowering effects and that these characteristics of azelnidipine underlies its HR-lowering effects when administered systemically.

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“…It has been suggested that CCBs may activate the SNS and increase heart rates because of their potent hypotensive action (42,43). Unlike other dihydropyridine-type CCBs, AZ has a unique action of inhibiting SNS, and it indeed decreases, rather than increases, the heart rate after oral administration (6,44). Antihypertensive treatment with AZ attenuates reflex-induced sympathetic activation and enhances endothelial nitric oxide synthase expression levels in the brain as well as in the heart and aorta (45).…”

Section: Fig 2 the Correlation Between The % Change Of Blood Pressumentioning

confidence: 99%

Combination Therapy with Renin-Angiotensin System Inhibitors and the Calcium Channel Blocker Azelnidipine Decreases Plasma Inflammatory Markers and Urinary Oxidative Stress Markers in Patients with Diabetic Nephropathy

Ogawa¹,

Mori²,

Nako³

et al. 2008

Hypertens Res

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Efficacy of Azelnidipine on Home Blood Pressure and Pulse Rate in Patients with Essential Hypertension: Comparison with Amlodipine

Abstract: Recently it has been recognized that not only blood pressure (BP) but also pulse rate (

Cited by 21 publications

References 18 publications

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Combination therapy based on the angiotensin receptor blocker olmesartan for vascular protection in spontaneously hypertensive rats

Chronotropic Effects of Azelnidipine, a Slow- and Long-acting Dihydropyridine-type Calcium Channel Blocker, in Anesthetized Dogs: A Comparison With Amlodipine

Combination Therapy with Renin-Angiotensin System Inhibitors and the Calcium Channel Blocker Azelnidipine Decreases Plasma Inflammatory Markers and Urinary Oxidative Stress Markers in Patients with Diabetic Nephropathy

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