Long-term effects of L- and N-type calcium channel blocker on uric acid levels and left atrial volume in hypertensive patients

• Published in: Heart and vessels Vol. 31; no. 11; pp. 1826 - 1833
• Main Authors: Masaki, Mitsuru, Mano, Toshiaki, Eguchi, Akiyo, Fujiwara, Shohei, Sugahara, Masataka, Hirotani, Shinichi, Tsujino, Takeshi, Komamura, Kazuo, Koshiba, Masahiro, Masuyama, Tohru
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.11.2016; Springer Nature B.V
• Subjects: Amlodipine - therapeutic use; Antagonist drugs; Atrial Function, Left - drug effects; Atrial Remodeling - drug effects; Biomarkers - blood; Biomedical Engineering and Bioengineering; Blood Pressure - drug effects; Calcium Channel Blockers - therapeutic use; Calcium Channels, L-Type - drug effects; Calcium Channels, N-Type - drug effects; Cardiac Surgery; Cardiology; China; Clinical outcomes; Diastole; Dihydropyridines - therapeutic use; Down-Regulation; Drug therapy; Echocardiography, Doppler; Female; Humans; Hypertension; Hypertension - blood; Hypertension - diagnostic imaging; Hypertension - drug therapy; Hypertension - physiopathology; Hyperuricemia - blood; Hyperuricemia - diagnosis; Hyperuricemia - drug therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Time Factors; Treatment Outcome; Uric Acid - blood; Vascular Surgery; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - drug effects; Hypertension; Diastolic dysfunction; L- and N-type calcium channel blocking drugs; Uric acid
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-016-0796-z

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.