Effects of cilnidipine, an L/N-type calcium channel blocker, on carotid atherosclerosis in Japanese post-stroke hypertensive patients: Results from the CA-ATTEND study

Abstract

Aims: Although several antihypertensive agents reduced the carotid intima -media thickness (IMT), it remains unclear whether those agents affect the interadventitial diameter (IAD). We aimed to examine whether cilnidipine, an L/N-type calcium channel blocker, reduced the common carotid IMT or IAD in post-stroke hypertensive patients. Methods: The common carotid IMT and IAD were measured at the start of cilnidipine treatment and 12 months from that. The changes in the mean max-IMT or IAD between baseline and the 12-month follow-up were evaluated and compared between the thick group (max-IMT ≥1.1 mm) and the normal group (max-IMT −1.1 mm). Results: A total of 603 post-stroke hypertensive subjects (mean age−69.3 yr, 378 males) were included in the analysis. At baseline, IAD was increased stepwise according to the value of max-IMT (p for trend −0.001). Among them, 326 subjects were followed up for 12 months. The mean max-IMT from baseline to 12 months did not change in the normal group (−0.01 mm, 95% confidence interval [CI] −0.03 to 0.01, n−170), whereas a significant reduction was observed in the thick group (−0.09 mm, 95% CI −0.13 to −0.05, n−156). The mean IAD was significantly reduced during the study period in the normal group (−0.14 mm, 95% CI −0.22 to −0.05) as well as in the thick group (−0.12 mm, 95% CI −0.21 to −0.03). Conclusions: Cilnidipine promoted the regression of common carotid IMT in post-stroke hypertensive patients, especially in the thick group. Cilnidipine also reduced the IAD in both normal and thick groups.