Differential effects of azelnidipine and amlodipine on sympathetic nerve activity in patients with primary hypertension

書誌事項

公開日
2014-09
資源種別
journal article
DOI
  • 10.1097/hjh.0000000000000270
公開者
Ovid Technologies (Wolters Kluwer Health)

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説明

Calcium channel blockers (CCBs) are used as antihypertensive agents and have a strong vasodilatory effect; however, the sympathetic activation mediated by baroreflex might cause adverse effects. A recently developed CCB, azelnidipine, decreases the heart rate (HR) while lowering blood pressure (BP), possibly by inhibiting sympathetic nerve activity in animal models. In this study, we evaluated whether azelnidipine inhibited sympathetic nerve activity, compared to amlodipine, in primary hypertensive patients.We conducted a prospective, randomized, open-label, and crossover study of 14 patients. We measured the patients' BP, HR and baroreflex sensitivity, and directly recorded muscle sympathetic nerve activity (MSNA), via microneurography, after treatment with either CCB for 8 weeks.Although systolic and diastolic BPs did not differ between the azelnidipine and amlodipine groups, the HR in the azelnidipine group significantly decreased compared with that in the amlodipine group. MSNA was significantly reduced in the azelnidipine compared with the amlodipine group (47.7 ± 14.9 vs. 61.5 ± 10.7  bursts per 100 beats, P  0.05). However, no significant difference was observed in terms of the baroreflex control of HR, or MSNA, between the two groups.Our data show, first, that azelnidipine, compared with amlodipine, exerted a favorable effect on sympathetic nerve activity, without affecting baroreflex sensitivity, in hypertensive patients. These results indicate that azelnidipine might be useful for treating hypertensive patients, in whom hypertension is complicated by heart failure and ischemic heart disease.

収録刊行物

  • Journal of Hypertension

    Journal of Hypertension 32 (9), 1898-1904, 2014-09

    Ovid Technologies (Wolters Kluwer Health)

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