Antihypertensive efficacy and tolerability of barnidipine hydrochloride inpatients with renal parenchymal hypertension

Objective: The goal of this study was to assess the therapeutic efficacy an d tolerability of barnidipine hydrochloride in patients with renal parenchy mal hypertension. Methods: The study consisted of 2 phases: a 2-week observation period and a 6- to 8-week treatment period. During the observation period, 1 placebo ca psule was administered orally once daily for 2 weeks. One capsule of barnid ipine 5 mg was given orally once daily during the initial 2 weeks of the tr eatment period. If the target hypotensive effect tie, a decrease in systoli c blood pressure [SBP] >20 mm Hg or in diastolic blood pressure [DBP] >10 m m Hg) was not achieved during the initial treatment period, the daily dose of barnidipine could be increased in 5-mg increments at 2-week intervals up to a maximum daily dose of 15 mg, Patients were instructed to discontinue all medications that could affect blood pressure. Results: Thirty-seven patients with renal parenchymal hypertension mere enr olled. Of these, 31 completed the study. Six patients dropped out: 2 volunt arily discontinued treatment during the observation period; 2 stopped hospi tal visits at 4 and 6 weeks, respectively; and 2 discontinued because of ad verse events. At the end of the 2-week observation period, the median value s for baseline SEP and DBP were 170 mm Hg (range, 140-200 mm Hg) and 110 mm Hg (range, 95-130 mm Hg), respectively. After the initial 2 weeks of treat ment, the respective values were 150 mm Hg (range, 120-185 mm Hg) and 100 m m Hg (range, 80-130 mm Hg), After 4 weeks of treatment, median SEP was 145 mm Hg (range, 120-180 mm Hg) and median DBP was 90 mm Hg (range, 80-130 mm Hg), At the end of treatment, the respective SEP and DBP values were 140 mm Hg (range, 120-180 mm Hg) and 90 mm Hg (range, 70-130 mm Hg), AU of these reductions were significant compared with baseline values (P < 0.01). Blood pressure was considered to be reduced in 25 patients (80.6%), slightly red uced in 1 (3.2%), unchanged in 4 (12.9%), and slightly elevated in 1 (3.2%) . Heart rate was not significantly affected. No significant adverse events were observed during or after treatment with barnidipine. Conclusion: Results of this study suggest that barnidipine may be helpful i n treating patients with renal parenchymal hypertension.