The Effects of the L/N-Type Calcium Channel Blocker (Cilnidipine) on Sympathetic Hyperactive Morning Hypertension: Results From ACHIEVE-ONE

Abstract

The Ambulatory Blood Pressure Control and Home Blood Pressure (Morning and Evening) Lowering By N-Channel Blocker Cilnidipine (ACHIEVE-ONE) trial is a large-scale clinical study on blood pressure (BP) and pulse rate (PR) in the real world with use of cilnidipine, a unique L/N-type Ca channel blocker, possessing a suppressive action on increased sympathetic activity in patients with essential hypertension. The effects of cilnidipine on morning hypertension were examined. The authors examined 2319 patients treated with cilnidipine for 12weeks. Clinic systolic BP (SBP) decreased by 19.6mm Hg from 155.0mm Hg, whereas morning SBP decreased by 17.0mm Hg from 152.9mm Hg after 12-week cilnidipine treatment. Cilnidipine reduced both morning SBP and PR more markedly in patients with higher baseline morning SBP (-3.2mm Hg and -1.3beats per minute in the first quartile of morning SBP, -30.9mm Hg and -3.2beats per minute in the fourth quartile), and also reduced both morning PR and SBP more markedly in patients with higher baseline morning PR (0.6beats per minute and -15.6mm Hg in <70beats per minute, and -9.7beats per minute and -20.2mm Hg in ≥85beats per minute). Cilnidipine significantly reduced BP and PR in hypertensive patients at the clinic and at home, especially with higher BP and PR in the morning. © 2012 Wiley Periodicals, Inc.