Effects of Cilnidipine, an L/N-Type Calcium Channel Blocker, on Carotid Atherosclerosis in Japanese Post-Stroke Hypertensive Patients: Results from the CA-ATTEND Study.

Abstract

AIMS:

Although several antihypertensive agents reduced the carotid intima-media thickness (IMT), it remains unclear whether those agents affect the interadventitial diameter (IAD). We aimed to examine whether cilnidipine, an L/N-type calcium channel blocker, reduced the common carotid IMT or IAD in post-stroke hypertensive patients.

METHODS:

The common carotid IMT and IAD were measured at the start of cilnidipine treatment and 12 months from that. The changes in the mean max-IMT or IAD between baseline and the 12-month follow-up were evaluated and compared between the thick group (max-IMT ≥1.1 mm) and the normal group (max-IMT ＜1.1 mm).

RESULTS:

A total of 603 post-stroke hypertensive subjects (mean age=69.3 yr, 378 males) were included in the analysis. At baseline, IAD was increased stepwise according to the value of max-IMT (p for trend ＜0.001). Among them, 326 subjects were followed up for 12 months. The mean max-IMT from baseline to 12 months did not change in the normal group (－0.01 mm, 95% confidence interval [CI] －0.03 to 0.01, n=170), whereas a significant reduction was observed in the thick group (－0.09 mm, 95% CI －0.13 to －0.05, n=156). The mean IAD was significantly reduced during the study period in the normal group (－0.14 mm, 95% CI －0.22 to －0.05) as well as in the thick group (－0.12 mm, 95% CI －0.21 to －0.03).

CONCLUSIONS:

Cilnidipine promoted the regression of common carotid IMT in post-stroke hypertensive patients, especially in the thick group. Cilnidipine also reduced the IAD in both normal and thick groups.

• Authors: Tomohisa Nezu, Naohisa Hosomi, Shiro Aoki, Noriyuki Suzuki, Tsukasa Teshima, Hitoshi Sugii, Shinobu Nagahama, Yoshiki Kurose, Hirofumi Maruyama, Masayasu Matsumoto
• Journal: Journal of atherosclerosis and thrombosis (J Atheroscler Thromb) Vol. 25 Issue 6 Pg. 490-504 (Jun 01 2018) ISSN: 1880-3873 [Electronic] Japan
• PMID: 29225324 (Publication Type: Journal Article)

Chemical References

• Antihypertensive Agents
• Calcium Channel Blockers
• Calcium Channels, L-Type
• Dihydropyridines
• cilnidipine

Topics

• Aged
• Antihypertensive Agents (adverse effects)
• Calcium Channel Blockers (therapeutic use)
• Calcium Channels, L-Type (chemistry)
• Carotid Artery Diseases (chemically induced, drug therapy)
• Carotid Artery, Common (drug effects, pathology)
• Carotid Intima-Media Thickness
• Dihydropyridines (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Hypertension (complications, drug therapy)
• Male
• Prognosis
• Stroke (complications, drug therapy)