DOI: https://doi.org/10.22141/2224-1485.3-4.64-65.2019.177842

Results of an international symposium on arterial hypertension and calcium channel blockers: focus on lercanidipine

O.L. Rekovets

Abstract


The review presents the results of a symposium with the participation of main experts in the field of hypertension from all over the world on the topic “Current perspective on the use of calcium channel blockers in the treatment of hypertensive patients”. It was noted that all 5 currently widely used classes of antihypertensive drugs, including calcium channel blockers (CCBs), are able to lower blood pressure and constitute the basis of antihypertensive therapy. But the ability to reduce the risk of other cardiovascular events may vary between classes. For example, CCBs have been shown to reduce the risk of stroke, major cardiovascular events, cardiovascular and all-cause mortality. The discussion also touched upon the fact that CCBs are included in the category of “best drugs” in the management of target organ damage. So, for left ventricular hypertrophy, angiotensin-converting enzyme inhibitors and CCBs were named the best, for reducing small arteries remodeling — angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and CCBs. New CCBs are expected to be among the best treatments for chronic kidney disease. When considering individual CCB representatives, the main focus was on lercanidipine, a relatively new third generation lipophilic dihydropyridine with high vascular selectivity. In addition to all the properties listed above, it is characterized by a number of additional remarkable features: the slow onset of action, leading to a gradual decrease in blood pressure and the prevention of reflex tachycardia; fewer side effects, especially ankle and pedal edema. For example, the edema frequency in the group with lercanidipine was 9.3 %, in the group with amlodipine 19 %. Unlike many other CCBs, lercanidipine dilates both afferent and efferent arterioles that potentially reduces glomerular hypertension and may contribute to nephroprotection. For example, the combination of lercanidipine + enalapril steadily reduced albuminuria, while amlodipine + enalapril did not. In general, the efficacy of lercanidipine has been confirmed in patients with varying degrees of hypertension; in patients of all ages (young, middle-aged and elderly); with isolated systolic hypertension; in patients with diabetes and renal impairment. The drug was well tolerated.

Keywords


calcium channel blockers; lercanidipine; arterial hypertension; review

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