Comparison of the effects of amlodipine and cilnidipine on blood pressure, heart rate, proteinuria and lipid profile in hypertensive patients

Background: Hypertension is a widespread public health problem and a major risk factor. Amlodipine, a calcium channel blocker is frequently used in the treatment of hypertension. Since Amlodipine primarily L-type calcium channel blocker (CCB) and thus reduces blood pressure, it stimulates sympathetic nerve activity leading to reflex increase in heart rate. Cilnidipine, a new type of CCB which can inhibit L- type calcium channels but also N-type calcium channels. We compare the clinical effectiveness of Amlodipine and Cilnidipine on blood pressure, heart rate, proteinuria and lipid profile in hypertensive patients. Methods: The study was a prospective, randomized, open label comparison, total ninety five patients were recruited for study in which 45 patients received 5-10mg Amlodipine and other 55 patients of same age groups received 10-20mg Cilnidipine. 15 patients in Amlodipine group and 18 patients in Cilnidipine group were diabetic, whereas 12 and 14 patients were proteinuric in Amlodipine and Cilnidipine group respectively. Results: Both the groups were well matched in term of age, weight, clinical findings and laboratory values. Both the drug significantly reduced both systolic (SBP) and diastolic blood pressure (DSP). In the Amlodipine group the pulse rate (PR) after treatment tended to be higher than those before treatment. In the Cilnidipine group there was decrease in PR after treatment. Unlike Amlodipine, Cilnidipine decreased urinary protein excretion and in diabetic patients reduced serum triglyceride. Conclusions: The study indicates that unlike Amlodipine, Cilnidipine which inhibits L-and N-type calcium channels will be useful for patients with hypertension and cardiovascular disease, diabetes mellitus or renal disease and proves to be a better alternative to existing calcium channel blockers.