Key result
Third-generation calcium antagonists demonstrate high antihypertensive efficacy, nephroprotective activity comparable to ACE inhibitors, and better safety than second-generation agents.
Third-generation calcium antagonists like lercanidipine offer effective antihypertensive action with improved safety profiles and potential nephroprotective benefits compared to older generations.
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Supports potential preference for third-generation agents in hypertension; leaves open need for prospective RCTs to confirm benefits.
The paper considers the specific features of the pharmacokinetics of third-generation dihydropyridines (membrane-controlled pharmacokinetics). Comparative trials have shown their longer action and high efficacy, which are highly competitive with those of major groups of antihypertensive drugs. Lercanidipine proved to have the nephroprotective activity comparable with that of angiotensin-converting enzyme (ACE) inhibitors. They have been demonstrated to have a better tolerance and safety than second-generation calcium antagonists.
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А. А. Кириченко (2013) conducted a review in Hypertension. Third-generation calcium antagonists (e.g., lercanidipine) vs. Second-generation calcium antagonists and ACE inhibitors was evaluated. Third-generation calcium antagonists demonstrate high antihypertensive efficacy, nephroprotective activity comparable to ACE inhibitors, and better safety than second-generation agents.
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