Manidipine's unique blockade of T-type calcium channels provides non-haemodynamic benefits such as reduced microalbuminuria, making it a potentially advantageous calcium channel blocker for hypertensive patients with diabetes.
Manidipine may confer renal benefits in diabetic hypertension; leaves open whether this warrants preferential use over other dihydropyridines in trials.
The combination of renin-angiotensin system blockers with calcium channel blockers appears to be one of the most effective options for treating hypertension and diabetes.Nevertheless, not all calcium blockers behave in the same manner. Manidipine, unlike other third-generation dihydropyridine derived drugs, blocks T-type calcium channels present in the efferent glomerular arterioles, reducing intraglomerular pressure and microalbuminuria. In addition,T-type channels are related to proliferation, inflammation,fibrosis, vasoconstriction and activation of the renin-angiotensin system. The inhibition of these factors could explain the non-haemodynamic effects of manidipine as compared to other blockers.
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Buset-Ríos et al. (2011) studied this question.
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