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Sympatho‐inhibitory and Parasympatho‐excitatory Effects of N‐type Calcium Channel Blocker Antagonist for the Patients with Hypertension
Author(s) -
Kishi Takuya,
Hirooka Yoshitaka,
Sunagawa Kenji
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.6.a891-a
Subject(s) - baroreflex , medicine , blood pressure , calcium channel blocker , heart rate , n type calcium channel , antagonist , heart rate variability , channel blocker , calcium channel , endocrinology , anesthesia , cardiology , calcium , t type calcium channel , receptor
Calcium channel blocker(CCB), widely used as anti‐hypertensive drug, is known not to decrease heart rate. Among CCB, N‐type CCB, Cilnidipine, is reported not to increase the heart rate. However, it has not been determined whether cilnidipine has the sympatho‐inhibitory effects or not. The aim of this study was to determine the effect of cilnidipine on sympathetic and parasympathetic nerve activity, and baroreflex sensitivity. We studied 5 hypertensive patients treated with 10mg cilnidipine (10mg Group) and 5 hypertensive patients treated with 20mg cilnidipine (20mg Group). Before the treatment and 6 months after the treatment, we measured the blood pressure, spontaneous baroreflex sensitivity (BRS), heart rate variability (HRV), and blood pressure variability (BPV). After 6 months, mean blood pressure (MBP) and the low‐frequency component of systolic BPV (LF‐SBP), as the parameter of sympathetic nerve activity, was significantly decreased in both groups, and the effects were stronger in 20mg group than in 10mg group (ΔSBP/SBP (before the treatment); −24% vs −13%, P<0.01, ΔLF‐SBP/LF‐SBP (before the treatment); −48% vs −33%, P<0.01) ). The high‐frequency component of HRV, as the parameter of parasympathetic nerve activity, and BRS were significantly increased in 20mg group, but not significant in 10mg group. These results suggest that 6 months treatment with cilnidipine for hypertension has the sympatho‐inhibtory effect, and 20mg cilnidipine improve the parasympathetic nerve activity and baroreflex sensitivity in patients with hypertension. We consider that cilnidipine is useful for the patients with hypertension, because the increase in sympathetic nerve activity cause various cardiovascular diseases and worse prognosis.