Barnidipine or Lercanidipine on Echocardiographic Parameters in Hypertensive, Type 2 Diabetics with Left Ventricular Hypertrophy: A Randomized Clinical Trial

Giuseppe Derosa, Amedeo Mugellini, Fabrizio Querci, Ivano Franzetti, Rosa Maria Pesce, Angela D'Angelo, Pamela Maffioli, Giuseppe Derosa, Amedeo Mugellini, Fabrizio Querci, Ivano Franzetti, Rosa Maria Pesce, Angela D'Angelo, Pamela Maffioli

Abstract

The aim of this study was to evaluate the effects of lercanidipine or barnidipine on echocardiographic parameters, in hypertensive, type 2 diabetics with left ventricular hypertrophy. One hundred and forty-four patients were randomized to lercanidipine, 20 mg/day, or barnidipine, 20 mg/day, in addition to losartan, 100 mg/day, for 6 months. We evaluated: blood pressure, fasting plasma glucose (FPG), glycated hemoglobin (HbA(1c)), lipid profile, creatinine, estimated glomerular filtration rate (eGFR), sodium, potassium, and acid uric. Echocardiography was performed at baseline and after 6 months. Both lercanidipine and barnidipine decreased blood pressure. Left ventricular mass index was reduced to a greater extent with barnidipine + losartan. Interventricular septal thickness in diastole was reduced by barnidipine + losartan. Posterior wall thickness in diastole was decreased by both treatments, even if barnidipine + losartan were more effective. Ratio of peak early diastolic filling velocity to peak filling velocity at atrial contraction was increased by barnidipine + losartan, but not by lercanidipine + losartan. Finally, isovolumetric relaxation and time and left atrial volume index were reduced by barnidipine + losartan, while lercanidipine + losartan did not affect them. In conclusion, barnidipine + losartan provided a greater improvement of echocardiographic parameters compared to lercanidipine + losartan.

Trial registration: ClinicalTrials.gov NCT02064218.

Figures

Figure 1. *p
Figure 1. *p
SBP: systolic blood pressure; DPB: diastolic blood pressure.

References

    1. Levy D. et al. Prognostic complications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N. Engl. J. Med. 322, 1561–1566 (1990).
    1. Lorell B. H. & Carabello B. A. Left ventricular hypertrophy: pathogenesis, detection and prognosis. Circulation 102, 470–479 (2000).
    1. Dodson P. M. et al. Hypertensive retinopathy: a review of existing classification systems and a suggestion for a simplified grading system. J. Hum. Hypertens. 10, 93–98 (1996).
    1. Nielsen F. S. et al. Left ventricular hypertrophy in non-insulin-dependent diabetic patients with and without diabetic nephropathy. Diabet. Med. 14, 538–546 (1997).
    1. Devereux R. B. et al. Impact of diabetes on cardiac structure and function: the strong heart study. Circulation 101, 2271–2276 (2000).
    1. Palmieri V. et al. Strong Heart Study. Relation of left ventricular hypertrophy to inflammation and albuminuria in adults with type 2 diabetes: the strong heart study. Diabetes Care 26, 2764–2769 (2003).
    1. Nichols G. A. et al. The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes Care 27, 1879–1884 (2004).
    1. Verdecchia P. et al. Changes in cardiovascular risk by reduction of left ventricular mass in hypertension: a meta-analysis. Am. J. Hypertens. 16, 895–899 (2003).
    1. Devereux R. B. et al. Prognostic significance of left ventricular mass change during treatment of hypertension. J.A.M.A. 292, 2350–2356 (2004).
    1. Derosa G. & Maffioli P. Assessment and management of left ventricula1r hypertrophy in Type 2 diabetes patients with high blood pressure. Expert Rev. Cardiovasc. Ther. 11, 719–728 (2013).
    1. Liau C. S. Barnidipine: a new calcium channel blocker for hypertension treatment. Expert Rev. Cardiovasc. Ther. 3, 207–213 (2005).
    1. Malhotra H. S. & Plosker G. L. Barnidipine. Drugs 61, 989–996 (2001).
    1. Bang L. M., Chapman T. M. & Goa K. L. Lercanidipine: a review of its efficacy in the management of hypertension. Drugs 63, 2449–2472 (2003).
    1. Derosa G. et al. Vildagliptin compared to glimepiride on post-prandial lipemia and on insulin resistance in type 2 diabetic patients. Metabolism 63, 957–967 (2014).
    1. Derosa G. et al. Effects of canrenone in patients with metabolic syndrome. Expert Opin. Pharmacother. 14, 2161–2169 (2013).
    1. Bunn H. F., Gabbay K. H. & Gallop P. M. The glycosylation of haemoglobin. Relevance to diabetes mellitus. Science 200, 21–27 (1978).
    1. Lang R. M. et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J. Am. Soc. Echocardiogr. 18, 1440–1463 (2005).
    1. Devereux R. B. et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am. J. Cardiol. 57, 450–458 (1986).
    1. Winer B. J. Statistical Principles in Experimental Design. 2nd ed, McGraw-Hill, New York, (1971).
    1. Mancia G. et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur. Heart J. 34, 2159–2219 (2013).
    1. Kosegawa I. et al. Effect of the vasodilatory beta-blocker, nipradilol, and Ca-antagonist, barnidipine, on insulin sensitivity in patients with essential hypertension. Clin. Exp. Hypertens. 20, 751–761 (1998).
    1. Matsumura K. et al. f or the COMFORT Investigators. Effect of losartan on serum uric acid in hypertension treated with a diuretic: the COMFORT study. Clin. Exp. Hypertens. 10.3109/10641963.2014.933968 (2014).
    1. Tomassoni D., Sabbatini M. & Amenta F. Effect of different dihydropyridine-type Ca2+ antagonists on left ventricle hypertrophy and coronary changes in spontaneously hypertensive rats. J. Cardiovasc. Pharmacol. 41, 544–552 (2003).
    1. Angeli F. et al. Effects of barnidipine on blood pressure and left ventricular diastolic function in patients with hypertension and metabolic syndrome: A 12- week, open-label noncomparison study. Curr. Ther. Res. Clin. Exp. 69, 207–220 (2008).

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner