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A randomized open-label study to compare the effects of amlodipine and cilnidipine on heart rate and proteinuria in subjects with hypertension with proteinuria

Ajay D Shanbhag, Hema Narasimhe Gowda, Laxmegowda.




Abstract

Background: Calcium channel blockers (CCBs) are a commonly used class of drugs for the treatment of hypertension. Cilnidipine is a novel CCB with a dual L/N-type CCB property, thus favoring additional renal and cardiovascular protection.

Aims and Objectives: The aims of this study were to evaluate the effects and their linearity across the time frame of amlodipine and cilnidipine in hypertensive subjects with proteinuria on heart rate and proteinuria.

Materials and Methods: A prospective, randomized, open-label study was carried out on hypertensive subjects with proteinuria attending the General Medicine OPD in K.R Hospital, Mysore. 60 subjects satisfying the inclusion and exclusion criteria were included in the study. Heart rate and urine protein-to-creatinine ratio (UPCR) were measured at baseline and at 12 weeks along with weekly heart rate monitoring. The dose of amlodipine and cilnidipine was titrated depending on the blood pressure control. Descriptive statistics, independent sample t-test, repeated measure ANOVA, and CramerÂ’s V-test were used to analyze the results.

Results: Demographic profile was well matched in both the groups. The heart rate was significantly higher at 12 weeks in subjects treated with amlodipine, while subjects in the cilnidipine group showed a significantly higher heart rate compared to baseline (P < 0.05). Furthermore, while the UPCR was significantly decreased in the cilnidipine group, a significant increase was seen in the amlodipine group, thereby resulting in a significant intergroup difference (P < 0.05).

Conclusion: Cilnidipine is, thus, a better alternative in hypertensive patients with proteinuria due to its cardioprotective and renoprotective actions.

Key words: Proteinuria; Heart Rate; Amlodipine; Cilnidipine






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