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Blood pressure control with cilnidipine treatment in Japanese post-stroke hypertensive patients: The CA-ATTEND study
Shiro Aoki1, Naohisa Hosomi1, Tomohisa Nezu1
1a Department of Clinical Neuroscience and Therapeutics , Hiroshima University Graduate School of Biomedical and Health Sciences , Hiroshima , Japan.
Insights
Cilnidipine effectively controlled blood pressure in post-stroke patients. This calcium-channel blocker demonstrated good tolerability and safety in a large Japanese study.
Area of Science:
- Cardiology
- Pharmacology
- Neurology
Background:
- Effective blood pressure management is crucial for post-stroke patients.
- Calcium-channel blockers are recommended for treating hypertension in this population.
Purpose of the Study:
- To evaluate the efficacy and safety of cilnidipine in Japanese patients with post-stroke hypertension.
- To assess blood pressure control and adverse reactions in a real-world clinical setting.
Main Methods:
- A large-scale, prospective, post-marketing surveillance study.
- Involved 2667 post-stroke hypertensive patients treated with cilnidipine.
- Monitored clinic and home blood pressures over 12 months.
Main Results:
- Cilnidipine significantly reduced both clinic and home blood pressures within 2 months, sustained for 12 months.
- The proportion of patients achieving controlled blood pressure (<140/90 mmHg) increased from 21.5% to 65.3%.
- Adverse events occurred in 8.9% of patients, with good overall tolerability.
Conclusions:
- Cilnidipine is effective for blood pressure control in Japanese post-stroke hypertensive patients.
- The drug is well-tolerated and safe in a real-world clinical setting.
- Effectiveness was consistent across different stroke subtypes.
Abstract:
Blood pressure control is important in post-stroke hypertensive patients and antihypertensive treatment is recommended for such patients. Ca-channel blockers are recommended as the medications of choice for the treatment of post-stroke patients. Here, we report the results of a large-scale prospective post-marketing surveillance study of post-stroke hypertensive patients (n = 2667, male 60.4%, 69.0 ± 10.9 years) treated with cilnidipine, with regard to blood pressure control and adverse reactions. Cilnidipine treatment caused a decrease in both clinic and home blood pressures 2 months after the beginning of treatment, and the decreased blood pressure was maintained until the end of 12 months' observation. The proportion of patients in whom clinic blood pressure was well controlled (<140/90 mmHg) increased from 21.5% to 65.3% in cilnidipine treatment, with no differences in effectiveness among the various clinical subtypes of stroke. In total, 346 adverse events occurred, with an overall incidence of 8.9% (238 of 2667 patients). In the elderly group, specifically, a fall and a hip fracture each occurred in 1 (0.1%) patient. These results indicate that cilnidipine was effective in treating uncontrolled blood pressure and was well tolerated in Japanese post-stroke hypertensive patients in a real-world clinical setting.
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