Effects of L‐/N‐Type Calcium Channel Blockers on Angiotensin II–Renin Feedback in Hypertensive Patients

Figure 1. Study design. Patients received either 10 mg per day of cilnidipine, which was increased to a daily dose of 20 mg, or 5 mg per day of amlodipine, which was increased to a daily dose of 10 mg. Doses of RAS inhibitors were not altered when the combination with amlodipine failed to reduce BP to the target level within 3 months. Instead, additional antihypertensive medications, such as diuretics, were administered to achieve the target BP.

Figure 2. Changes in BP during the study period. BP was similar between the cilnidipine and amlodipine groups. The systolic and diastolic BP values were significantly reduced in both groups after 6 months of treatment. BP, blood pressure. (a) Systolic blood pressure. (b) diastolic blood pressure.

Figure 3. Changes in heart rate during the study period. Heart rate was almost the same between the cilnidipine and amlodipine groups and remained unchanged after 6 months of treatment.

Figure 4. Changes in the urine albumin-to-creatinine ratio before and after the treatment. After 6 months of treatment, the urine albumin-to-creatinine ratio was suppressed in the cilnidipine group but not the amlodipine group.

Figure 5. Changes in the plasma Ang I (a) and Ang II (b) levels before and after the treatment. After 6 months of treatment, significant increases in both plasma Ang I and Ang II levels were observed in the amlodipine group but not in the cilnidipine group. Ang I, angiotensin I; Ang II, angiotensin II.

Figure 6. Plasma aldosterone levels and PRA before and after treatment. Although there were no significant differences in plasma aldosterone levels of PRA between the 2 groups, both showed nonsignificant increases in the amlodipine group but not in the cilnidipine group. PRA, plasma renin activity.

Figure 7. Changes in the ratio of Ang-(1–7) to Ang II in plasma before and after treatment. After 6 months of treatment, the cilnidipine group had a significantly higher ratio Ang-(1–7) to Ang II in the plasma than the amlodipine group. Ang-(1–7), angiotensin; Ang II, angiotensin II.