Lipophilic
dihydropyridines have many theoretical and practical clinical advantages owing to their long permanence at the cell membrane. They have a greater chance of smoothly and permanently reducing blood pressure over 24 h than other
dihydropyridines, a feature that may have positive prognostic implications since 24-h blood pressure is more closely related to the end-organ damage of
hypertension. They may avoid the sympathetic activation consequent to an excessive early-dose
hypotension, which is responsible for an increase in 24-h blood-pressure variability and reflex
tachycardia, two phenomena that may worsen the prognosis of hypertensive patients. A further advantage which has been shown in experimental and clinical settings is the possibility of reducing the extension and progression of atherogenic lesions in blood vessels, which are responsible for cardiovascular complications in
hypertension. Some of these features have been shown by the novel lipophilic
dihydropyridine lercanidipine. In particular, clinical studies have shown that (i) this
drug is effective in homogeneously reducing blood pressure over 24 h, (ii) its
antihypertensive effect is similar to that of some common
antihypertensive drugs, and (iii) the rate of adverse events experienced with
lercanidipine is no greater than that observed with other
antihypertensive drugs, with special reference to non-lipophilic
calcium antagonists. In particular, studies performed so far have shown that
lercanidipine does not exert a dangerous reflex
tachycardia.