An Open Label Parallel Group Study to Assess the Effects of Amlodipine and Cilnidipine on Pulse Wave Velocity and Augmentation Pressures in Mild to Moderate Essential Hypertensive Patients

Abstract

Introduction: Hypertension is a major cardiovascular risk factor, which affects both large and small arteries. Because of the associated morbidity and mortality and the cost to society, it is an important public health challenge. Population based studies have reported that large artery stiffness is an important determinant of cardiovascular events and mortality in general population and in patients with hypertension. This study was designed to compare the effects of 8 weeks blood pressure control using Amlodepine and cilnidipine on haemodynamic parameters and vascular indices in mild to moderate hypertensive patients. Materials and Methods: A total of 60 patients were enrolled in the study. Thirty patients were randomly allocated to either Amlodipine 5 mg OD or Cilnidipine 10 mg OD for duration of eight weeks. Blood Pressure (BP), Heart Rate (HR), carotid-femoral Pulse Wave Velocity (cf PWV), Augmentation Index (AIx) and Aortic augmentation pressure (AoAP) were measured at baseline and at the end of eight weeks. Results: The mean change in the central artery stiffness from baseline to week-8 in the Amlodipine group as compared to Cilnidipine group cf PWV -139.3±27.7 vs. -234.1±74.8 cm/s p=<0.0001, AoAP -3.8±1.5 vs. -5.6±3.3 mm of Hg p=0.008 and AIx -6.8±2.4 vs. -10.8±4.4%, p=<0.0001 respectively. Conclusion: This study showed that the L/N-type calcium channel antagonist Cilnidipine has a similar antihypertensive action to Amlodipine, but is superior in improving the arterial stiffness.

Keywords

• arterial stiffness
• augmentation index
• carotid-femoral pulse wave velocity