Korean Circ J.  2010 Oct;40(10):514-519. 10.4070/kcj.2010.40.10.514.

Beneficial Effect of Efonidipine, an L- and T-Type Dual Calcium Channel Blocker, on Heart Rate and Blood Pressure in Patients With Mild-to-Moderate Essential Hypertension

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Bundang Hospital, Seongnam, Korea. cheolkim@plaza.snu.ac.kr
  • 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, Korea.
  • 4Department of Internal Medicine, Daegu Catholic University College of Medicine, Daegu, Korea.
  • 5Department of Internal Medicine, Chonbuk National University College of Medicine, Jeonju, Korea.
  • 6Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Efonidipine hydrochloride, an L- and T-type dual calcium channel blocker, is suggested to have a heart rate (HR)-slowing action in addition to a blood pressure (BP)-lowering effect. The aim of this study was to determine the effect of efonidipine on HR and BP in patients with mild-to-moderate hypertension.
SUBJECTS AND METHODS
In a multi-center, prospective, open-labeled, single-armed study, we enrolled 53 patients who had mild-to-moderate hypertension {sitting diastolic BP (SiDBP) 90-110 mmHg}. After a 2-week washout, eligible patients were treated with efonidipine (40 mg once daily for 12 weeks). The primary end point was the change in HR from baseline to week 12. The secondary end-point included the change in trough sitting BP and 24-hour mean BP between baseline and week 12. Laboratory and clinical adverse events were monitored at each study visit (4, 8, and 12 weeks).
RESULTS
Fifty-two patients were included in the intention-to-treat analysis. After 12 weeks of treatment with efonidipine, the resting HR decreased significantly from baseline to week 12 {from 81.5+/-5.3 to 71.8+/-9.9 beats/minute (difference, -9.9+/-9.0 beats/minute), p<0.0001}. The trough BP {sitting systolic blood pressure (SiSBP) and SiDBP} and 24-hour mean BP also decreased significantly (SiSBP: from 144.6+/-8.2 to 132.9+/-13.5 mmHg, p<0.0001; SiDBP: from 96.9+/-5.4 to 88.3+/-8.6 mmHg, p<0.0001, 24-hour mean systolic BP: from 140.4+/-13.5 to 133.8+/-11.6 mmHg, p<0.0001; 24-hour mean diastolic BP: from 91.7+/-8.7 to 87.5+/-9.5 mmHg, p<0.0001).
CONCLUSION
Efonidipine was effective in controlling both HR and BP in patients with mild-to-moderate hypertension.

Keyword

Calcium channel blockers; Heart rate; Hypertension

MeSH Terms

Blood Pressure
Calcium
Calcium Channel Blockers
Calcium Channels
Dihydropyridines
Heart
Heart Rate
Humans
Hypertension
Nitrophenols
Organophosphorus Compounds
Prospective Studies
Calcium
Calcium Channel Blockers
Calcium Channels
Dihydropyridines
Nitrophenols
Organophosphorus Compounds

Figure

  • Fig. 1 Study design. SiSBP: sitting systolic blood pressure, SiDBP: sitting diastolic blood pressure.

  • Fig. 2 Disposition of study patients.

  • Fig. 3 Effects of efonidipine on heart rate at 4, 8, and 12 weeks. The reduction in heart rate was maintained during the active treatment period. ITT: intention-to-treat, PP: per-protocol.


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