Antihypertensive Effects of Long-Acting Calcium Channel Blockers on Hemodialysis Days – A Randomized Crossover Trial between Benidipine and Nifedipine CR

Abstract

Background/Aims: Since antihypertensive effects of most calcium channel blockers largely depend on their plasma concentrations, a rapid increase in blood pressure may occur as circulating levels of such blockers decrease after hemodialysis. Thus, the effects of benidipine and nifedipine CR (extended-release coated tablets, Adalat CR^®), which are long-acting calcium channel blockers, on post-hemodialytic blood pressures were investigated. Methods: A randomized crossover trial was carried out with 10 hypertensive patients on chronic maintenance hemodialysis. Patients were assigned to receive benidipine (4–8 mg/day) or nifedipine CR (20–40 mg/day), and after 4 weeks, 24-hour ambulatory blood pressure monitoring was performed on the day of hemodialysis and blood samples were obtained before and after hemodialysis to measure plasma concentrations of the blockers. The calcium channel blockers were then exchanged in each patient and the same protocol was repeated. Results: The pattern of fluctuation of blood pressure differed markedly between the treatment with benidipine and nifedipine CR. Under treatment with nifedipine CR, rapid increase in blood pressure was observed after hemodialysis, while blood pressure remained at favorable levels with benidipine. Plasma concentrations of the blockers were significantly decreased by hemodialysis. Conclusion: Benidipine exerts more sustained antihypertensive effects than expected from its disposition in plasma. The stable depressor effects of benidipine even after hemodialysis may contribute to favorable control of blood pressure in this population.

Journal

Journal ID (publisher-id): NEC

Journal ID (nlm-ta): Nephron Clin Pract

Journal ID (doi): 10.1159/issn.1660-2110

Title: Nephron Clinical Practice

Publisher: S. Karger AG

ISSN (Electronic): 1660-2110

Publication date Subscription-year: 2004

Publication date (Print): June 2004

Publication date (Electronic): 17 November 2004

Volume: 97

Issue: 2

Pages: c49-c53

Affiliations

^aDepartment of Internal Medicine, Komono Kosei Hospital, Komono, ^bDepartment of Internal Medicine, Johoku Hospital, Nagoya, and ^cInternal Medicine and Molecular Science, Nagoya City University Graduate School, Nagoya, Japan

Article

Publisher ID: 78400 Other ID: Nephron Clin Pract 2004;97:c49–c53

DOI: 10.1159/000078400

PubMed ID: 15218330

Copyright statement: © 2004 S. Karger AG, Basel

License:

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Page count

Figures: 1, Tables: 2, References: 20, Pages: 1

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Categories

Subject: Original Paper