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Long-term effects of L- and N-type calcium channel blocker on uric acid levels and left atrial volume in hypertensive patients

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Abstract

Left ventricular (LV) diastolic dysfunction is associated with hypertension and hyperuricemia. However, it is not clear whether the L- and N-type calcium channel blocker will improve LV diastolic dysfunction through the reduction of uric acid. The aim of this study was to investigate the effects of anti-hypertensive therapy, the L- and N-type calcium channel blocker, cilnidipine or the L-type calcium channel blocker, amlodipine, on left atrial reverse remodeling and uric acid in hypertensive patients. We studied 62 patients with untreated hypertension, randomly assigned to cilnidipine or amlodipine for 48 weeks. LV diastolic function was assessed with the left atrial volume index (LAVI), mitral early diastolic wave (E), tissue Doppler early diastolic velocity (E′) and the ratio (E/E′). Serum uric acid levels were measured before and after treatment. After treatment, systolic and diastolic blood pressures equally dropped in both groups. LAVI, E/E′, heart rate and uric acid levels decreased at 48 weeks in the cilnidipine group but not in the amlodipine group. The % change from baseline to 48 weeks in LAVI, E wave, E/E′ and uric acid levels were significantly lower in the cilnidipine group than in the amlodipine group. Larger %-drop in uric acid levels were associated with larger %-reduction of LAVI (p < 0.01). L- and N-type calcium channel blocker but not L-type calcium channel blocker may improve LV diastolic function in hypertensive patients, at least partially through the decrease in uric acid levels.

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Abbreviations

CCB:

Calcium channel blocker

UA:

Uric acid

LAV:

Left atrial volume

LV:

Left ventricular

RAS:

Renin–angiotensin system

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

LAVI:

Left atrial volume index

LVMI:

Left ventricular mass index

RWT:

Relative wall thickness

E :

Peak velocities of early diastolic phase

A :

Late diastolic phase of mitral inflow

E′ :

Mitral annulus velocities

HR:

Heart rate

LAD:

Left atrial diameter

LVEDD:

Left ventricular end-diastolic diameter

LVESD:

Left ventricular end-systolic diameter

LVEF:

Left ventricular ejection fraction

LVMI:

Left ventricular mass index

DT:

Deceleration time

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Acknowledgments

We thank Ms. M. Tanaka, S. Makihara and C. Misumi for their excellent technical assistance in the acquisition of echocardiographic tracings. This work was supported by a Grant-in-Aid for Researchers, Hyogo College of Medicine, 2014.

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Authors and Affiliations

  1. Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan

    Mitsuru Masaki, Toshiaki Mano, Akiyo Eguchi, Shohei Fujiwara, Masataka Sugahara, Shinichi Hirotani, Kazuo Komamura & Tohru Masuyama

  2. Division of Clinical Laboratory Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Mitsuru Masaki, Akiyo Eguchi & Masahiro Koshiba

  3. Center for Health Evaluation and Promotion, Hyogo College of Medicine Hospital, Nishinomiya, Japan

    Mitsuru Masaki, Akiyo Eguchi & Masahiro Koshiba

  4. Department of Pharmacy, School of Pharmacy, Hyogo University of Health Sciences, Kobe, Japan

    Takeshi Tsujino

  5. Osaka Clinic, Takeda Pharmaceutical Company Limited, Osaka, Japan

    Kazuo Komamura

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  1. Mitsuru Masaki
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Correspondence to Toshiaki Mano.

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Masaki, M., Mano, T., Eguchi, A. et al. Long-term effects of L- and N-type calcium channel blocker on uric acid levels and left atrial volume in hypertensive patients. Heart Vessels 31, 1826–1833 (2016). https://doi.org/10.1007/s00380-016-0796-z

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