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1.
[Biological age and the pain syndrome at diabetic polyneuropathy].
Galkin, VV, Nesterova, MV, Emel'ianov, VV
Advances in gerontology = Uspekhi gerontologii. 2011;(2):303-7
Abstract
Patients with diabetic polyneuropathy were examined to study their biological age, rate of aging and pain syndrome. More rapid rate of aging was revealed in patients with diabetic polyneuropathy and pain syndrome. Using Duloxetin and Gabapentin is reliable to decrease the display of pain syndrome in diabetic polyneuropathy patients. Against the background of pain syndrome therapy the rate of aging is noticed to decrease along with the regression of pain syndrome. The medicines of Duloxetin and Gabapentin which are used during depression and epilepsy protect against aging.
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2.
[Renal protective effects of benidipine and valsartan in primary hypertension patients with proteinuria].
Peng, T, Hu, Z, Guo, L, Yang, XD, Xia, Q, Li, XH, Jiang, B, Pei, F, Song, J
Zhonghua xin xue guan bing za zhi. 2010;(1):20-2
Abstract
OBJECTIVE To compare the renal protective effects between calcium channel blocker benidipine and angiotensin II receptor blocker valsartan in primary hypertension patients with proteinuria. METHODS A total of 236 patients were divided to low (< 1 g/24 h) and high (1 - 3 g/24 h) proteinuria groups and treated with benidipine (8 mg/d) or valsartan (80 mg/d) for 48 weeks. Blood pressure, glomerular filtration rate (GFR) and 24 h protein were measured at baseline, 12, 24 and 48 weeks. RESULTS Blood pressure was significantly and equally reduced in all treated groups (all P < 0.05 vs. baseline). GFR was also significantly and equally improved in all treated groups after 24 weeks treatments (all P < 0.05 at 24 weeks and 48 weeks). Proteinuria reduction at 24 and 48 weeks was more significant in patients treated with valsartan compared to patients treated with benidipine in low proteinuria group [24 weeks: (0.27 +/- 0.07) g/24 h vs. (0.39 +/- 0.06) g/24 h, P < 0.01; 48 weeks: (0.18 +/- 0.01) g/24 h vs. (0.30 +/- 0.05) g/24 h, P < 0.01]. CONCLUSION The renal protection efficacy of valsartan and benidipine was similar in primary hypertensive patients with proteinuria.
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3.
[Some aspects of the clinical use of lercamen (lercadipine)].
Kavtaradze, GV, Kostava, MT, Gvetadze, LG
Georgian medical news. 2009;(172-173):50-3
Abstract
The paper deals with the comparative study of the effects of lercamen (lercadipine) and amlodipine, two third-generation long-acting calcium channel blocker medicine of the dihydropyridine type used in the treatment of hypertension. 80 patients of both sexes, aged from 48 to 76 were treated with lercamen (10-20 mg) or amlodipine (10 mg) for twelve weeks. Some adverse reactions of the above mentioned drugs such as headache, ankle oedema and others were observed and studied with great care. A two-week treatment with lercamen (10 mg) resulted in significant decrease of both systolic and diastolic blood pressure in 74% patients. Further decrease of blood pressure was observed during the following 10 weeks. The doze of lercamen had to be doubled for 26% of patients. After 12 weeks blood pressure in lercamen group was 126+/-4.5/80.4+/-5.3 mmHg (p<0.01 versus baseline). Amlodipine caused similar decrease of blood pressure. Sympathetic activation occurs neither with lecramene not with amlodipine during chronic therapy. Less adverse drug reactions were observed among lercamen group, which equaled with 12% than among the amlodipine group, which was 26,3%. We believe that adverse reactions are weakly expressed in lercamen group than in amlodipine group due to high lypophility and unique membrane kinetic of lercamen. Lercamen has proved not only better efficiency but also better endurance in chronic treatment of essential hypertension in patients.
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4.
Influence of ATII blockers and calcium channel blockers on renal vascular resistance in patients with essential hypertension.
Delić-Brkljacić, D, Galesić, K, Ivanac, G, Manola, S, Pintarić, H, Stambuk, K, Gaćina, P, Radeljić, V
Collegium antropologicum. 2009;(4):1129-38
Abstract
Doppler can evaluate renal vascular resistance, and resistance index (RI) highly correlates with blood pressure and renal function in various pathological conditions. Purpose of the study was to measure and compare renal Doppler indices in patients with newly-diagnosed essential hypertension (EH) and in healthy subjects; to determine changes of Doppler indices in patients after six-months monotherapy with either the AT II blocker (valsartane) or calcium channel blocker (niphedipine); to determine which drug has better renoprotective effect. 65 healthy controls were examined, as well as 69 patients with the newly-diagnosed EH, without signs of the target organ damage. Duplex Doppler US of interlobar intrarenal arteries was performed, and RI, acceleration index (AI) and acceleration time (AT) measured. Antihypertensive monotherapy was performed with vaslartane in 34 patients and with niphedipine in 35 patients. Doppler was repeated after the six-months therapy. RI in patients with the 1. stage of EH is significantly higher compared to the controls (p < 0.001), and significantly lower compared to the stage 2. of EH (p < 0.001). The significant decrease of systolic (p < 0.001) and dyastolic blood pressure (BP) (p < 0.001) was noted after the therapy. RI in healthy examinees (RI = 0.59 +/- 0.023) is significantly lower than in EH (RI = 0.66 +/- 0.26) (p < 0.001), while AI is significantly higher (p < 0.001), and AT is significantly lower (p < 0.001). In patients treated with valsartane and those treated with niphedipine, the RIs are significantly lower than before (p < 0.001), while AIs were significantly higher, and ATs were significantly lower after the therapy after the therapy with both drugs. RIs in patients treated with valsartane (RI = 0.615 +/- 0.036) are significantly lower than RIs of patients treated with niphedipine (RI = 0.642 +/- 0.030) (p < 0.01) after therapy. Regression analysis for the predictive values of RI, AT, AI in relation to the age-standardized values of systolic and diastolic BP of healthy examinees and patients with hypertension has demonstrated that RI is the strongest and statistically significant predictor in all groups of examinees. Six-months monotherapy of EH with valsartane or with niphedipine is equally efficient in the decrease of the blood pressure, but valsartane has more favourable effect on kidney. Resistance index measured in intrarenal arteries is the best parameter of Doppler spectrum in the evaluation of the effects of antihypertensive therapy on the kidney.
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5.
Arterial wave reflection during antihypertensive therapy with barnidipine: a 6-month, open-label study using an integrated cardiovascular ultrasound approach in patients with newly diagnosed hypertension.
Palombo, C, Malshi, E, Morizzo, C, Rakebrandt, F, Corretti, V, Santini, F, Fraser, AG, Kozakova, M
Clinical therapeutics. 2009;(12):2873-85
Abstract
BACKGROUND Increased central aortic pressure resulting from large artery stiffening and increased wave reflection is associated with higher hypertension-related morbidity. OBJECTIVE The goal of this study was to evaluate the effects of a vasodilator-based therapy with the calcium channel blocker barnidipine on arterial stiffness, wave reflection, and left ventricular (LV) performance using an integrated cardiovascular ultrasound approach (including wave intensity analysis). METHODS Newly diagnosed, previously untreated patients with grade 1 or 2 essential hypertension (systolic blood pressure [BP] > or =140 and <180 mm Hg, and/or diastolic BP > or =90 and <110 mm Hg), and with no signs of clinical cardiovascular disease, were eligible for study. Carotid artery mechanics were investigated at baseline and after 3 and 6 months of barnidipine therapy (10-20 mg once daily, according to an open-label design) using a double-beam carotid ultrasound technique. This provided a simultaneous recording of diameter-derived pressure and flow velocity signals and allowed analysis of wave intensity. Indices of local arterial stiffness and wave reflection, as well as separated forward and backward pressure waves, were estimated. LV geometry, mass, and systolic and diastolic performance were also assessed using Doppler echocardiography. All ultrasound examinations and readings were performed by investigators blinded to patient demographics and treatment phase. Normotensive control subjects (office BP <140/90 mm Hg) were included as a reference group. RESULTS Twenty-one white, treatment-naive patients with hypertension (mean [SD] age, 58 [8] years; 14 males; mean body mass index, 27 [5] kg/m(2); mean BP, 159 [14]/96 [5] mm Hg) were enrolled. Twenty normotensive subjects comprised the control group. Compared with the control subjects, patients with hypertension had a higher mean augmentation index ([AIx] 22.0% [7.0%] vs 13.1% [5.2%]; P < 0.01), Peterson's pressure-strain elastic modulus (175 [49] vs 126 [41] kPa; P < 0.01), and forward and backward pressure waves (137 [17] vs 108 [7] mm Hg [P < 0.001] and 21 [6] vs 17 [5] mm Hg [P < 0.05], respectively) at baseline. After 6 months of barnidipine treatment, mean office BP in the patients with hypertension decreased from 159 (14)/96 (5) mm Hg at baseline to 138 (16)/81 (9) mm Hg (P < 0.001) due to a significant reduction in forward and backward pressure waves, and AIx decreased to 17.0% (8.0%) (P < 0.01); there were no significant changes in indices of intrinsic arterial stiffness. A significant direct relationship between AIx and pulse pressure (r = 0.45 [P < 0.05]) was observed at baseline in hypertensive patients but not after therapy (r = 0.26 [P = NS]). Mean stress-adjusted LV midwall shortening increased from 110% (17%) at baseline to 118% (13%) at 6 months (P < 0.05), which was comparable to baseline values in the control subjects (119% [10%]). CONCLUSION In these middle-aged patients with newly diagnosed mild to moderate hypertension, vasodilator therapy with barnidipine reduced central BP by a parallel reduction of forward and backward pressure waves, together with a later arrival of the reflected waves, with no significant changes in intrinsic arterial stiffness.
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6.
Does calcium channel blocker improvement of perfusion impact the functioning of kidney graft in early period after transplantation?
Nowacki, M, Droździk, M, Safranow, K, Kaminski, M, Sulikowski, T, Zietek, Z, Romanowski, M, Sienko, J, Mizerski, A, Ignaczak, E, et al
Transplantation proceedings. 2008;(4):1056-8
Abstract
The aim of the study was to evaluate the influence of reduced vascular resistance following calcium channel blocker verapamil administration on kidney function at 3 months after transplantation. A group of 48 kidneys received 100 microg verapamil by injection directly into renal artery before starting perfusion. The control group included 48 paired kidneys without verapamil addition. Calcium channel blocker therapy with verapamil greatly decreased renal vascular resistance but it did not affect graft function. Administration of calcium channel blockers improved kidney function in the early period after transplantation. A better-functioning graft seems to be based more on metabolic than hemodynamic effects.
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7.
Electron paramagnetic resonance investigation on modulatory effect of benidipine on membrane fluidity of erythrocytes in essential hypertension.
Tsuda, K
Heart and vessels. 2008;(2):134-9
Abstract
It has been shown that benidipine, a long-lasting calcium (Ca) channel blocker, may exert its protective effect against vascular disorders by increasing nitric oxide (NO) production. The purpose of the present study was to investigate whether orally administered benidipine might influence the membrane function in patients with essential hypertension. We measured the membrane fluidity of erythrocytes by using an electron paramagnetic resonance (EPR) and spin-labeling method. In the preliminary study using erythrocytes obtained from healthy volunteers, benidipine decreased the order parameter (S) for 5-nitroxide stearate (5-NS) and the peak height ratio (ho/h-1) for 16-NS in the EPR spectra in vitro. The finding indicated that benidipine increased the membrane fluidity and improved the microviscosity of erythrocytes. In addition, it was demonstrated that the effect of benidipine on membrane fluidity of erythrocytes was significantly potentiated by the NO-substrate, L-arginine. In the separate series of the study, we observed that orally administered benidipine for 4 weeks significantly increased the membrane fluidity of erythrocytes with a concomitant increase in plasma NO metabolite levels in hypertensive subjects. The results of the present study demonstrated that benidipine might increase the membrane fluidity and improve the microviscosity of erythrocytes both in vitro and in vivo, to some extent, by the NO-dependent mechanism. Furthermore, it is strongly suggested that orally administered benidipine might have a beneficial effect on the rheologic behavior of erythrocytes and the improvement of the microcirculation in hypertensive subjects.
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8.
Bedtime administration of cilnidipine controls morning hypertension.
Ashizawa, N, Seto, S, Shibata, Y, Yano, K
International heart journal. 2007;(5):597-603
Abstract
Morning blood pressure (BP) level plays an important role in the incidence of cardiovascular disease. Recently, Kario, et al proposed the usefulness of ME difference (morning minus evening systolic BP) and ME average (average of morning and evening systolic BP) for the evaluation of antihypertensive treatment. Cilnidipine is a novel calcium channel blocker (CCB) that exerts inhibitory actions not only on L-type but also on N-type calcium channels. We investigated the effect of bedtime administration of cilnidipine (10 mg) in addition to the antihypertensive treatment for uncontrolled morning hypertension. Twenty-three hypertensive outpatients (13 males and 10 females; mean age, 66.9 years) with stable antihypertensive medication and uncontrolled morning BP were studied using self-measured BP monitoring in the morning and evening. Morning SBP (P < 0.001) and DBP (P < 0.001) decreased significantly from 150.2 +/- 8.7 and 87.8 +/- 9.3 to 132.7 +/- 7.4 and 77.5 +/- 8.5 mmHg, respectively, after the addition of cilnidipine. Morning heart rate did not change (63.3 +/- 7.0 to 64.1 +/- 9.4). The evening SBP, but not DBP, decreased significantly after treatment. Both the ME average (P < 0.001) and ME difference (P < 0.01) significantly decreased from 143.0 +/- 9.2 and 14.3 +/- 12.4 to 131.3 +/- 7.2 and 2.8 +/- 9.2 mmHg after treatment, respectively. The microalbuminuria decreased from 39.6 +/- 13.2 to 27.3 +/- 8.4 mg/g Cr. In conclusion, L-/N-type CCB cilnidipine may be useful for patients with uncontrollable morning hypertension by reducing both ME average and ME difference.
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9.
[A nimodipine interventional study of patients with mild cognitive impairment].
Wang, W, Wang, LN, Zhang, XH, Ma, L, Li, DJ
Zhonghua nei ke za zhi. 2006;(4):274-6
Abstract
OBJECTIVE To observe the effect of nimodipine on the cognition status and the changes of metabolites in brain tissue in the patients with mild cognitive impairment (MCI) in order to evaluate the significance of intervening MCI with medication. METHODS 31 patients with MCI were selected 16 cases were in a treatment group taking nimodipine for 3 months besides taking basic internal medication and 15 cases in a control group taking only basic internal medication. Before and after treatment, multiple cognition tests were carried out in both groups and magnetic resonance spectroscopy (MRS) in Hippocampus region was carried out in 5 patients of the treatment group. RESULTS Verbal instant recall scores, symbol digit modalities test (SDMT) scores and mini-mental state examination (MMSE) total scores in the treatment group were improved significantly after treatment as compared with those in the control group (P < 0.05). CONCLUSION Nimodipine can improve memory ability as well as attention ability of the patients with MCI to a certain extent and make the general cognition function improved.
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10.
Effect of cilnidipine on left ventricular function in hypertensive patients as assessed by tissue Doppler Tei index.
Tan, HW, Li, L, Zhang, W, Ma, ZY, Zhong, XZ, Zhang, Y
Journal of human hypertension. 2006;(8):618-24
Abstract
Tissue Doppler Tei index is pointed to be more effective in the evaluation of global cardiac function than systolic and diastolic measurements alone in various heart diseases. This study was designed to assess the effect of cilnidipine on left ventricular function in hypertensive patients by using this index. A group of 40 hypertensives (mean age 55+/-8 years, range: 35-65) and 16 controls (mean age 52+/-9 years, range: 36-65) were included. Hypertensives were classified into non-left ventricular hypertrophy (NLVH) group (25 patients) and left ventricular hypertrophy (LVH) group (15 patients), and treated with cilnidipine for 2 months. Before and after treatment, the participants were examined by echocardiography. Tissue Doppler Tei index was calculated as diastolic time interval measured from end of late diastole to origin of early diastole (a') minus systolic Sm duration (b') divided by b', that is Tei index = (a'-b')/b'. Thirty-seven hypertensive patients finished the treatment. Tei index was significantly higher in NLVH and LVH groups than in control group, and in LVH group than in NLVH group (0.44+/-0.07 vs 0.28+/-0.06, P < 0.001; 0.51+/-0.13 vs 0.28+/-0.06, P < 0.001; 0.51+/-0.13 vs 0.44+/-0.07, P < 0.05). After treatment, Tei index was significantly decreased (0.40+/-0.11 vs 0.46+/-0.10, P < 0.0001); systolic blood pressure and diastolic blood pressure were also decreased significantly. In conclusion, Tei index is impaired in hypertensives before development of ventricular hypertrophy and impairment is more prominent in hypertrophy. Cilnidipine can improve left ventricular function. Tissue Doppler Tei index is gaining importance in evaluating LV function after drug intervention in hypertensive patients.