Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension

Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Luca Corradi, Andrea Rinaldi, Giuseppe Derosa, Paola Preti

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

This study aimed to compare the effects of two long-acting dihydropyridine calcium channel blockers (CCBs) with different pharmacologic properties, lercanidipine and nifedipine Gastro-Intestinal Therapeutic System (GITS), in the chronic treatment of essential hypertension. After a 4-week placebo run-in period, 60 patients of both sexes were randomly treated with lercanidipine 10 to 20 mg or nifedipine GITS 30 to 60 mg taken orally for 48 weeks, according to a double-blind, parallel group design. For the first 4 weeks of treatment, the lowest dose of each drug was used, followed by higher doses if diastolic blood pressure (BP) was >90 mm Hg. At the end of the placebo period and after 4, 8, 12, 24, and 48 weeks of active treatment BP, heart rate (HR), and plasma norepinephrine (NE) levels were assessed. Lercanidipine and nifedipine GITS similarly reduced BP values after 48 weeks (-21.7/15.9 mm Hg and -20.7/14.6 mm Hg, respectively, both P <.001 v placebo), with no change in HR. Despite the similar lack of effect on HR, the two drugs displayed different influences on plasma NE, which was significantly increased by nifedipine GITS (+56 pg/mL, P <.05 v placebo) but not by lercanidipine. These findings suggest that 1) sympathetic activation occurs during chronic therapy with nifedipine GITS but not with lercanidipine, which might be related to the different pharmacologic characteristics of the two CCBs at the doses evaluated; and 2) nifedipine GITS seems to activate peripheral but not cardiac sympathetic nerves, consistent with differing regulation of cardiac and peripheral sympathetic activity.

Original languageEnglish
Pages (from-to)596-599
Number of pages4
JournalAmerican Journal of Hypertension
Volume16
Issue number7
DOIs
Publication statusPublished - Jul 1 2003

Fingerprint

Nifedipine
Norepinephrine
Hypertension
Placebos
Blood Pressure
Therapeutics
Heart Rate
Calcium Channel Blockers
lercanidipine
Pharmaceutical Preparations

Keywords

  • Hypertension
  • Lercanidipine
  • Nifedipine GITS
  • Norepinephrine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension. / Fogari, Roberto; Mugellini, Amedeo; Zoppi, Annalisa; Corradi, Luca; Rinaldi, Andrea; Derosa, Giuseppe; Preti, Paola.

In: American Journal of Hypertension, Vol. 16, No. 7, 01.07.2003, p. 596-599.

Research output: Contribution to journalArticle

@article{0f90bca1421c4d508261b19f7ffa8a74,
title = "Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension",
abstract = "This study aimed to compare the effects of two long-acting dihydropyridine calcium channel blockers (CCBs) with different pharmacologic properties, lercanidipine and nifedipine Gastro-Intestinal Therapeutic System (GITS), in the chronic treatment of essential hypertension. After a 4-week placebo run-in period, 60 patients of both sexes were randomly treated with lercanidipine 10 to 20 mg or nifedipine GITS 30 to 60 mg taken orally for 48 weeks, according to a double-blind, parallel group design. For the first 4 weeks of treatment, the lowest dose of each drug was used, followed by higher doses if diastolic blood pressure (BP) was >90 mm Hg. At the end of the placebo period and after 4, 8, 12, 24, and 48 weeks of active treatment BP, heart rate (HR), and plasma norepinephrine (NE) levels were assessed. Lercanidipine and nifedipine GITS similarly reduced BP values after 48 weeks (-21.7/15.9 mm Hg and -20.7/14.6 mm Hg, respectively, both P <.001 v placebo), with no change in HR. Despite the similar lack of effect on HR, the two drugs displayed different influences on plasma NE, which was significantly increased by nifedipine GITS (+56 pg/mL, P <.05 v placebo) but not by lercanidipine. These findings suggest that 1) sympathetic activation occurs during chronic therapy with nifedipine GITS but not with lercanidipine, which might be related to the different pharmacologic characteristics of the two CCBs at the doses evaluated; and 2) nifedipine GITS seems to activate peripheral but not cardiac sympathetic nerves, consistent with differing regulation of cardiac and peripheral sympathetic activity.",
keywords = "Hypertension, Lercanidipine, Nifedipine GITS, Norepinephrine",
author = "Roberto Fogari and Amedeo Mugellini and Annalisa Zoppi and Luca Corradi and Andrea Rinaldi and Giuseppe Derosa and Paola Preti",
year = "2003",
month = "7",
day = "1",
doi = "10.1016/S0895-7061(03)00901-4",
language = "English",
volume = "16",
pages = "596--599",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Differential effects of lercanidipine and nifedipine GITS on plasma norepinephrine in chronic treatment of hypertension

AU - Fogari, Roberto

AU - Mugellini, Amedeo

AU - Zoppi, Annalisa

AU - Corradi, Luca

AU - Rinaldi, Andrea

AU - Derosa, Giuseppe

AU - Preti, Paola

PY - 2003/7/1

Y1 - 2003/7/1

N2 - This study aimed to compare the effects of two long-acting dihydropyridine calcium channel blockers (CCBs) with different pharmacologic properties, lercanidipine and nifedipine Gastro-Intestinal Therapeutic System (GITS), in the chronic treatment of essential hypertension. After a 4-week placebo run-in period, 60 patients of both sexes were randomly treated with lercanidipine 10 to 20 mg or nifedipine GITS 30 to 60 mg taken orally for 48 weeks, according to a double-blind, parallel group design. For the first 4 weeks of treatment, the lowest dose of each drug was used, followed by higher doses if diastolic blood pressure (BP) was >90 mm Hg. At the end of the placebo period and after 4, 8, 12, 24, and 48 weeks of active treatment BP, heart rate (HR), and plasma norepinephrine (NE) levels were assessed. Lercanidipine and nifedipine GITS similarly reduced BP values after 48 weeks (-21.7/15.9 mm Hg and -20.7/14.6 mm Hg, respectively, both P <.001 v placebo), with no change in HR. Despite the similar lack of effect on HR, the two drugs displayed different influences on plasma NE, which was significantly increased by nifedipine GITS (+56 pg/mL, P <.05 v placebo) but not by lercanidipine. These findings suggest that 1) sympathetic activation occurs during chronic therapy with nifedipine GITS but not with lercanidipine, which might be related to the different pharmacologic characteristics of the two CCBs at the doses evaluated; and 2) nifedipine GITS seems to activate peripheral but not cardiac sympathetic nerves, consistent with differing regulation of cardiac and peripheral sympathetic activity.

AB - This study aimed to compare the effects of two long-acting dihydropyridine calcium channel blockers (CCBs) with different pharmacologic properties, lercanidipine and nifedipine Gastro-Intestinal Therapeutic System (GITS), in the chronic treatment of essential hypertension. After a 4-week placebo run-in period, 60 patients of both sexes were randomly treated with lercanidipine 10 to 20 mg or nifedipine GITS 30 to 60 mg taken orally for 48 weeks, according to a double-blind, parallel group design. For the first 4 weeks of treatment, the lowest dose of each drug was used, followed by higher doses if diastolic blood pressure (BP) was >90 mm Hg. At the end of the placebo period and after 4, 8, 12, 24, and 48 weeks of active treatment BP, heart rate (HR), and plasma norepinephrine (NE) levels were assessed. Lercanidipine and nifedipine GITS similarly reduced BP values after 48 weeks (-21.7/15.9 mm Hg and -20.7/14.6 mm Hg, respectively, both P <.001 v placebo), with no change in HR. Despite the similar lack of effect on HR, the two drugs displayed different influences on plasma NE, which was significantly increased by nifedipine GITS (+56 pg/mL, P <.05 v placebo) but not by lercanidipine. These findings suggest that 1) sympathetic activation occurs during chronic therapy with nifedipine GITS but not with lercanidipine, which might be related to the different pharmacologic characteristics of the two CCBs at the doses evaluated; and 2) nifedipine GITS seems to activate peripheral but not cardiac sympathetic nerves, consistent with differing regulation of cardiac and peripheral sympathetic activity.

KW - Hypertension

KW - Lercanidipine

KW - Nifedipine GITS

KW - Norepinephrine

UR - http://www.scopus.com/inward/record.url?scp=0037898376&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037898376&partnerID=8YFLogxK

U2 - 10.1016/S0895-7061(03)00901-4

DO - 10.1016/S0895-7061(03)00901-4

M3 - Article

VL - 16

SP - 596

EP - 599

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 7

ER -