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Blood Pressure and Angina-Related Health Status During Benidipine Therapy: A Multicenter Real-World Cohort Study
Ayşegül Ülgen Kunak1, Tolga Kunak2, Ertan Aydın3
1Department of Cardiology, Antalya Training and Research Hospital, University of Health Sciences, Antalya 07100, Türkiye.
Insights
Benidipine effectively lowers blood pressure and improves angina-related health status in patients with hypertension or chronic coronary syndrome. However, the link between blood pressure reduction and symptom improvement is weak, suggesting other factors influence patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Health Outcomes Research
Background:
- Benidipine is a long-acting calcium channel blocker for hypertension and chronic coronary syndrome.
- The relationship between benidipine's blood pressure reduction and angina symptom improvement is not well-established.
- Real-world data on benidipine's impact on both blood pressure and patient-reported health status is needed.
Purpose of the Study:
- To evaluate the changes in blood pressure and angina-related health status in a large real-world cohort of patients treated with benidipine.
- To identify predictors of blood pressure reduction and symptomatic improvement.
- To explore differences in treatment response based on coronary artery disease status.
Main Methods:
- Prospective, multicenter, observational cohort study of 1659 patients with hypertension and/or chronic coronary syndrome.
- Assessment of systolic and diastolic blood pressure and Seattle Angina Questionnaire-7 (SAQ-7) scores at baseline and after 3 months.
- Multivariable linear regression and propensity score-matched analyses were used to evaluate outcomes.
Main Results:
- Benidipine therapy significantly reduced systolic blood pressure by 13.8 mmHg and diastolic blood pressure by 6.7 mmHg (p < 0.001).
- Mean SAQ-7 scores improved by 8.1 points (p < 0.001), indicating a clinically meaningful enhancement in angina-related health status.
- A weak correlation (r = 0.058, p = 0.023) was observed between changes in blood pressure and SAQ-7 scores, with baseline SAQ-7 and systolic blood pressure being the strongest predictors of their respective changes.
Conclusions:
- Benidipine therapy in a real-world setting leads to significant blood pressure reduction and clinically meaningful improvements in angina-related health status.
- Symptomatic improvement during benidipine treatment is weakly associated with the degree of blood pressure reduction.
- Further controlled studies are warranted to confirm these findings and elucidate the mechanisms of symptomatic improvement.
Abstract:
Background: Benidipine is a long-acting calcium channel blocker used for the treatment of hypertension and chronic coronary syndrome. Although it effectively lowers blood pressure (BP), the relationship between BP reduction and improvement in angina-related health status during benidipine therapy remains uncertain. This study evaluated changes in BP and patient-reported angina-related health status in a large real-world cohort. Methods: This prospective, multicenter, observational cohort study included 1659 patients with hypertension and/or chronic coronary syndrome who underwent baseline clinical assessment before initiation of benidipine therapy and were reassessed after 3 months. Changes in systolic and diastolic BP and Seattle Angina Questionnaire-7 (SAQ-7) scores were evaluated. Multivariable linear regression analyses were performed to identify predictors of BP reduction and symptomatic improvement. A propensity score-matched analysis according to coronary artery disease (CAD) status was conducted to further explore differences in treatment response. Results: The mean age was 62.2 ± 12.2 years, and 54.0% of participants were women. Systolic BP decreased by 13.8 mmHg and diastolic BP by 6.7 mmHg (both p < 0.001). Mean SAQ-7 score increased by 8.1 points (p < 0.001), exceeding the established threshold for clinically meaningful improvement. Baseline SAQ-7 score showed the strongest association with change in SAQ-7, whereas baseline systolic BP was the strongest predictor of BP reduction. The correlation between changes in systolic BP and SAQ-7 was weak (r = 0.058, p = 0.023). In the propensity score-matched cohort (n = 732), BP reduction was similar regardless of CAD status, whereas improvement in SAQ-7 was greater in patients without obstructive CAD. Conclusions: In this multicenter real-world cohort, benidipine therapy was associated with significant BP reduction and clinically meaningful improvement in angina-related health status over 3 months. Symptomatic improvement showed only a weak association with BP reduction. These findings should be interpreted within the limitations of an observational study and warrant confirmation in controlled comparative studies.
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