A054: Manidipine has less oedematigenous potential than amlodipine

• Published in: American journal of hypertension Vol. 13; no. S2; p. 131A
• Main Authors: Fogari, R., Malamani, G.D., Zoppi, A., Mugellini, A., Viscardi, A., Lastoria, C., Poletti, L.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2000
• Subjects: amlodipine; Ankle oedema; manidipine; norepinephrine
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(00)00587-2

Aim of this study was to compare the effect of Manidipine (M) vs Amlodipine (A) on pretibial subcutaneous tissue pressure (PSTP) and on ankle-foot volume (AFV) in hypertensive patients. Thirty mild to moderate hypertensive patients (DVP > 90 mmHg) aged 35 to 71 years were studied. After a 4 week placebo (P) period they were randomized to A 10 mg o.d. or to M 20 mg o.d. for 16 weeks; then after a new P period they were crossed to the alternative treatment for other 16 weeks. The last day of the P period and of each treatment period PSTP and AFV were evaluated in the morning (07.30–08.30) and in the evening (00.70–00.80) after a day of normal activity. PSTP was evaluated by connecting pretibial subcutaneous environment to a manometer, AFV though the water displacement. A blood sample to evaluate morning plasma Norepinephrine (NE) was obatained. The main results are as follows: (See Table) Morning AFV Evening AFV Morning PSTP Evening PSTP Morning NE Plac. 1295 ± 143 1349 ± 133 2,2 ± 1,7 2,9 ± 2 263,7 ± 69,9 Man. 1389 ± 152* 1437 ± 148* 2,9 ± 1.8* 3,9 ± 2,1* 268,4 ± 68,2 Aml. 1517 ± 169**° 1613 ± 172**° 3,9 ± 2,3**° 5,9 ± 2,5**° 319,6 ± 71,7*° *p < 0,05; **p < 0,01 vs Placebo °p < 0,05 vs Manidipine. NE changes show a positive correlation with morning AFV (r = 0,42, p < 0,01) and STP (r = 0,31, p < 0,05) changes. Both drug decreased BP at the same degree but no correlation was found between BP changes and AFV, PSTP or NE changes. In conclusion both drugs increase AFV and PSTP in the morning and in the evening, but the increase is always greater with A. In the evening A seems to amplify the effect of gravity, while M seems to act independently from gravity. The different effect ot the 2 drugs on NE and the correlation between morning AFV and NE changes seem suggest that the degree of reactive sympathetic activation could play a role in the oedematigenous potential of calcium antagonists.