1. Long-term effects of L- and N-type calcium channel blocker on uric acid levels and left atrial volume in hypertensive patients.
- Author
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Masaki M, Mano T, Eguchi A, Fujiwara S, Sugahara M, Hirotani S, Tsujino T, Komamura K, Koshiba M, and Masuyama T
- Subjects
- Biomarkers blood, Blood Pressure drug effects, China, Diastole, Down-Regulation, Echocardiography, Doppler, Female, Humans, Hypertension blood, Hypertension diagnostic imaging, Hypertension physiopathology, Hyperuricemia blood, Hyperuricemia diagnosis, Male, Middle Aged, Time Factors, Treatment Outcome, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Left drug effects, Amlodipine therapeutic use, Atrial Function, Left drug effects, Atrial Remodeling drug effects, Calcium Channel Blockers therapeutic use, Calcium Channels, L-Type drug effects, Calcium Channels, N-Type drug effects, Dihydropyridines therapeutic use, Hypertension drug therapy, Hyperuricemia drug therapy, Uric Acid blood, Ventricular Dysfunction, Left drug therapy
- Abstract
Left ventricular (LV) diastolic dysfunction is associated with hypertension and hyperuricemia. However, it is not clear whether the L- and N-type calcium channel blocker will improve LV diastolic dysfunction through the reduction of uric acid. The aim of this study was to investigate the effects of anti-hypertensive therapy, the L- and N-type calcium channel blocker, cilnidipine or the L-type calcium channel blocker, amlodipine, on left atrial reverse remodeling and uric acid in hypertensive patients. We studied 62 patients with untreated hypertension, randomly assigned to cilnidipine or amlodipine for 48 weeks. LV diastolic function was assessed with the left atrial volume index (LAVI), mitral early diastolic wave (E), tissue Doppler early diastolic velocity (E') and the ratio (E/E'). Serum uric acid levels were measured before and after treatment. After treatment, systolic and diastolic blood pressures equally dropped in both groups. LAVI, E/E', heart rate and uric acid levels decreased at 48 weeks in the cilnidipine group but not in the amlodipine group. The % change from baseline to 48 weeks in LAVI, E wave, E/E' and uric acid levels were significantly lower in the cilnidipine group than in the amlodipine group. Larger %-drop in uric acid levels were associated with larger %-reduction of LAVI (p < 0.01). L- and N-type calcium channel blocker but not L-type calcium channel blocker may improve LV diastolic function in hypertensive patients, at least partially through the decrease in uric acid levels.
- Published
- 2016
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