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1.
Treatment of hypertensive patients with diabetes: beyond blood pressure control and focus on manidipine.
Saiz Satjes, M, Martinez-Martin, FJ
Future cardiology. 2016;(4):435-47
Abstract
Renin-angiotensin system inhibitors should be considered as the first-line therapy in the treatment of patients with hypertension and diabetes. However, most of the diabetic subjects with hypertension require at least two drugs to achieve blood pressure targets. The ACCOMPLISH trial suggested that the best combination in the treatment of high-risk hypertensive patients should include a renin-angiotensin system inhibitor and a dihydropyridine. However, not all dihydropyridines block the same receptors. Those dihydropyridines that block T-type calcium channel blockers may provide additional advantages. A number of studies suggest that compared with amlodipine, manidipine have the same antihypertensive efficacy, but with a lesser risk of ankle edema. In addition, manidipine, but not amlodipine, significantly reduces urinary albumin excretion rates.
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2.
[Clinical efficacy of calcium channel blockers slow the third generation of lercanidipine in the treatment of patients with arterial hypertension and metabolic disorders (review)].
Tabidze, GA, Gezeli, TD, Tsibadze, TA, Dolidze, NM
Georgian medical news. 2015;(239):51-6
Abstract
Arterial hypertension is the most common risk factor in patients with metabolic disorders. In the selection of antihypertensive therapy it is necessary to consider not only the anti-hypertensive and organoprotective effects of drugs and their metabolic effects, which has prognostic value. Calcium antaginists, along. Lercanidipine related to the third generation dihydripyridine calcium antagonist, has been much more selective for the so-called slow calcium channels of vascular smooth muscle cells, which is associated with a good hypertensive, organo and metabolic action. Combination therapy with an ACE inhibitor and a calcium channel blocker is also a justified tactic for the management of patients with high-risk cardiovascular and metabolic disorders. Attention is paid new fixed combinations, including angiotensin converting enzyme inhibitors and calcium antagonists.
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3.
Azelnidipine and glucose tolerance: possible indications and treatment selection for hypertensive patients with metabolic disorders.
Shimada, K, Miyauchi, K, Daida, H
Expert review of cardiovascular therapy. 2015;(1):23-31
Abstract
Azelnidipine is a unique dihydropyridine calcium channel blocker with selectivity for L-type calcium channels that has been launched for the treatment of hypertension. Azelnidipine exhibits long-acting blood pressure-lowering effects without increasing heart rate. High blood pressure is associated with many metabolic disorders, including glucose intolerance and insulin resistance. Antihypertensive medications that interfere with various steps in the renin-angiotensin system improve glucose tolerance and insulin resistance; however, the effects of calcium channel blockers on glucose metabolism and insulin resistance remain controversial. Recent studies have demonstrated that azelnidipine could improve insulin resistance and glucose tolerance by potentially inhibiting sympathetic nerve activity. In addition, azelnidipine exhibits anti-inflammatory and anti-oxidative effects, suggesting that it is a beneficial antihypertensive agent with anti-atherogenic and cardioprotective effects for the treatment of not only hypertensive patients with glucose intolerance, but also those with metabolic disorders.
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4.
[24-hour perfect BP-lowering therapy using long-acting dihydropyridine calcium channel blockers].
Eguchi, K
Nihon rinsho. Japanese journal of clinical medicine. 2014;(8):1461-5
Abstract
Consistent BP lowering effect is essential for antihypertensive treatment. The dihydropyridine calcium channel blockers (CCB) are potent antihypertensive drugs, and have been reported to reduce future cardiovascular events. The effects of CCB on ambulatory BP have been reported, and could reduce not only daytime, but also nighttime and morning BP. Furthermore, when classified as circadian BP patterns--dippers, non-dippers, extreme dippers, and risers--, long-acting CCBs act to restore abnormal nocturnal dipping status toward a normal dipping pattern in hypertensive patients. These effects partly explain the favorable effects of CCB in preventing future cardiovascular events. This review summarizes the studies of long-acting dihydropyridine CCBs for the "24-hour perfect management of BP".
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5.
1, 4-Dihydropyridines: a class of pharmacologically important molecules.
Khedkar, SA, Auti, PB
Mini reviews in medicinal chemistry. 2014;(3):282-90
Abstract
The 1, 4-dihydropyridines (DHPs), a class of drugs possess a wide variety of biological and pharmacological actions. It represents one of the most important groups of calcium-channel modulating agents and has experienced widespread use in the treatment of cardiovascular disease which includes antihypertensive, antianginal, vasodilator and cardiac depressants activities. It also shows antibacterial, anticancer, antileishmanial, anticoagulant, anticonvulsant, antitubercular, antioxidant, antiulcer, CFTR, antimalarials, neuroprotection properties, HIV-1 protease inhibitors, antifertility activities and many more. There are many drugs available in market which contains 1, 4-dihydropyridines ring as basic scaffold. Basic motive of this review is to disclose various therapeutic applications of 1, 4-dihydropyridine derivatives reported by other researchers during their research work in 2001 to 2011.
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6.
Vasospastic angina and Ca channel blockers.
Minatoguchi, S
Current hypertension reviews. 2013;(3):219-23
Abstract
Coronary artery spasm is one of the causes of angina pectoris,acute myocardial infarction and ventricular fibrillation-related sudden death. It has been established that Ca channel blockers are protective against vasospastic angina (VSA) and treatment with Ca channel blockers provides a better prognosis of VSA. However, it is not still clarified what kinds of Ca channel blockers shows the best prognosis of VSA. We performed a meta-analysis in which 4Ca channel blockers amlodipine, nifedipine, benidipine and diltiazem were used for the treatment of VSA patients and found that among 4 Ca channel blockers, benidipine showed a statistically significant better prognostic effect on MACE than amlodipine, nifedipine or diltiazem.
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7.
Renoprotective effects of the L-/T-type calcium channel blocker benidipine in patients with hypertension.
Tomino, Y
Current hypertension reviews. 2013;(2):108-14
Abstract
The renoprotective effects of benidipine, a calcium channel blocker (CCB) developed in Japan, are reviewed herein. Benidipine has a sustained antihypertensive effect independent of its blood concentration since it binds to dihydropyridine (DHP) receptors via a "membrane approach" (approach to the cell membrane followed by long retention at the DHP binding site). Benidipine dilates glomerular afferent and efferent arterioles equally through inhibition of Ttype Ca channels. Thus, it may cause a decrease of intraglomerular pressure and is superior to CCBs (capable of inhibiting only L-type Ca channels) in terms of suppression of proteinuria. Additionally, benidipine suppresses worsening of renal function more powerfully than CCBs (suppressing only L-type Ca channels), allowing better prognosis as to renal function. The inhibitory effect of benidipine on T-type calcium channels results in the suppression of aldosterone formation in the adrenal glands and of oxidative stress induced by aldosterone. Thus, the aldosterone-inhibitory and antioxidant activities of benidipine mediated by inhibition of T-type calcium channels would result in renoprotection and suppression of disease progression in hypertensive patients with chronic kidney disease (CKD). If such patients have proteinuria, renin-angiotensin system (RAS) inhibitors are used as first-line drugs, but benidipine, as an L-/T-type CCB, is recommended when they require some concomitant drugs. Moreover, the superiority of RAS inhibitors has not been demonstrated in hypertensive patients with CKD and without proteinuria. Thus, in such patients, benidipine should be considered as a first-line antihypertensive drug.
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8.
[Lercanidipine in the treatment of arterial hypertension].
Minushkina, LO, Iosava, IK
Kardiologiia. 2012;(12):70-4
Abstract
This review summarizes data on the effectiveness of lercanidipine. Lercanidipine is dihydropyridine calcium antagonist of the third generation, characterized by high vazoselective, long duration of action and good antihypertensive effect. It may be assigned to elderly patients with isolated hypertension and has several important organoprotective properties. Treatment with lercanidipine promotes nephroprotection, reduction of left ventricular hypertrophy, improvement of elastic properties of blood vessels and reduction of central pressure. Sympathetic activation in the application of lercanidipine is virtually absent, that ensures its good tolerability and high adherence of patients to treatment.
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9.
Vascular and metabolic properties of manidipine.
Buset Ríos, N, Rodríguez Esparragón, F, Fernández-Andrade Rodríguez, C, Rodríguez Pérez, JC
Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia. 2011;(3):268-74
Abstract
The combination of renin-angiotensin system blockers with calcium channel blockers appears to be one of the most effective options for treating hypertension and diabetes.Nevertheless, not all calcium blockers behave in the same manner. Manidipine, unlike other third-generation dihydropyridine derived drugs, blocks T-type calcium channels present in the efferent glomerular arterioles, reducing intraglomerular pressure and microalbuminuria. In addition,T-type channels are related to proliferation, inflammation,fibrosis, vasoconstriction and activation of the renin-angiotensin system. The inhibition of these factors could explain the non-haemodynamic effects of manidipine as compared to other blockers.
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10.
Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: a scientific statement from the Asian Pacific Heart Association.
Wang, JG, Kario, K, Lau, T, Wei, YQ, Park, CG, Kim, CH, Huang, J, Zhang, W, Li, Y, Yan, P, et al
Hypertension research : official journal of the Japanese Society of Hypertension. 2011;(4):423-30
Abstract
Dihydropyridine calcium channel blockers (CCBs) are widely prescribed for the management of hypertension in Eastern Asians. In this study, the Asian Pacific Heart Association's Writing Committee reviewed randomized controlled trials that were conducted in the Eastern Asian region and compared a CCB with an antihypertensive drug of another class. These trials studied ambulatory blood pressure, measures of target organ damage and cardiovascular events as outcomes. Eleven trials studied ambulatory blood pressure in hypertensive patients and demonstrated that the 24-h blood pressure reduction with CCBs was greater than with other classes of antihypertensive drugs, with a weighted mean difference of 5 mm Hg systolic and 3 mm Hg diastolic. Twelve trials that studied various measurements of target organ damage in hypertensive patients produced inconsistent results when comparing CCBs and other classes of antihypertensive drugs. Four trials that studied the hard outcomes had limited power, but confirmed the findings of previous placebo-controlled trials in the region and actively controlled trials in Europe and North America; they suggested that CCBs provided superior protection against stroke and that some agents, such as amlodipine, also provided similar protection against myocardial infarction. In conclusion, CCBs should be recommended as a preferred drug for the management of hypertension in the Eastern Asian region to improve blood pressure control and to confront the aggravating epidemic of stroke and coronary heart disease.