Effect of Cilnidipine on Normal to Marginally Elevated Urine Albumin-Creatinine Ratio in Asymptomatic Non-Diabetic Hypertensive Patients: An Exponential Decay Curve Analysis

• Published in: Clinical drug investigation 2010-01, Vol.30 (10), p.699-706
• Main Authors: Nakatsu, Takaaki, Toyonaga, Shinji, Mashima, Keiichi, Yuki, Yoko, Nishitani, Aya, Ogawa, Hiroko, Miyoshi, Toru, Hirohata, Satoshi, Izumi, Reishi, Kusachi, Shozo
• Format: Article
• Language: English
• Subjects: Albuminuria - drug therapy; Albuminuria - etiology; Albuminuria - urine; Analysis; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Biomarkers - urine; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory; Calcium channel blockers; Calcium Channel Blockers - adverse effects; Calcium Channel Blockers - therapeutic use; Complications and side effects; Creatinine - urine; Development and progression; Dihydropyridines - adverse effects; Dihydropyridines - therapeutic use; Dosage and administration; Drug therapy; Humans; Hypertension; Hypertension - complications; Hypertension - drug therapy; Hypertension - physiopathology; Internal Medicine; Medicine; Medicine & Public Health; Models, Statistical; Nephelometry and Turbidimetry; Original Research Article; Pharmacology/Toxicology; Pharmacotherapy; Proteinuria; Risk factors; Time Factors; Treatment Outcome
• ISSN: 1173-2563; 1179-1918
• DOI: 10.2165/11538510-000000000-00000

Background: High-normal urinary albumin excretion has been reported to have clinical significance with respect to progression of proteinuria and hypertension. Objective: We analysed the effect of cilnidipine (10 mg/day) on morning systolic blood pressure (SBP) and urine albumin-creatinine ratio (UACR) in 16 non-diabetic hypertensive patients with a normal to marginally elevated UACR (mean ± SD 29.4 ± 21.7; range 7.5–72.9 mg/g creatinine). Methods: Sequential home BP and UACR data were fitted to a simple exponential function as follows: y = α · e −t/β + γ, where y is SBP (mmHg) or UACR (mg/g creatinine); α is the extent of the SBP (mmHg)- or UACR (mg/g creatinine)-lowering effect; β (days) is the time-constant for SBP or UACR decrease; t is the number of days after the start of cilnidipine administration; and γ is the finally stabilized SBP (mmHg) or UACR (mg/g creatinine). Results: Mean ± SD morning SBP and UACR decreased by 20.4 ±11.4mmHg and 15.2±13.1 mg/g creatinine, respectively, as determined by coefficient a. The mean ± SD time-constant for UACR decrease was significantly longer than that for BP decrease (43.5 ± 22.9 vs 15.4 ± 7.1 days). UACR reduction correlated with pre-treatment UACR values (correlation coefficient [R] = 0.88, p < 0.01) but not with BP decrease. Conclusions: The present study demonstrated that cilnidipine reduced UACR in hypertensive patients with normal to marginally elevated UACR independent of its BP-lowering effect.