Comparison of effects of benidipine and amlodipine on clinical and biochemical parameters in hypertensive patients: an observational study

Background: Hypertension is a widespread public health problem and a major risk factor for cardiovascular disease. Amlodipine, a calcium channel blocker, dilates arterioles by blocking L-type calcium channels. Benidipine inhibits L, N, and T type calcium channels. We compared the efficacy of Amlodipine and benidipine on blood pressure, pulse rate, proteinuria and lipid profile in hypertensive patients.Methods: The study was an observational, prospective, open label comparison. Eligible hypertensives were given either amlodipine (5mg/d) or benidipine (4mg/d). Clinical features and laboratory parameters were recorded initially and after 3 months. Adverse events were recorded with the help of a questionnaire. Compliance was assessed by return pill count.Results: Out of 35 patients, recruited for study, 16 received amlodipine and 17 were treated with benidipine and two were lost during follow up. Both the groups were well matched in terms of age, body weight, clinical findings and laboratory values. Both the drugs significantly (P <0.05) reduced systolic (142±16 to 138±15 vs.148±16 to 134±14mmHg) and diastolic blood pressure (81±9 to 79±7). In the Amlodipine group the pulse rate after treatment tended to be higher than before (70±9 to 72±10bpm). In the Benidipine group there was decrease in pulse-rate after treatment (69±9 to 67±9). Unlike Amlodipine, Benidipine significantly (P<0.05) decreased urinary protein excretion (1.0±1.2 to 1.1±1.4 vs. 1.4±2.5 to 1.1±1.7g/g-Cr) and serum triglycerides (125±25 to 120±23 vs 130±26 to 115±21mg/dl).Conclusions: In this study, amlodipine and benidipine were found to be be equally effective anti-hypertensive in patients with stage 1 hypertension. However, there was significant reduction in proteinuria and serum triglycerides in Benidipine group as compared to Amlodipine group. Benidipine may be a better alternative to existing calcium channel blockers.