Stress elevates blood pressure (BP) by increased sympathetic nerve activity
. Cilnidipine, a novel dihydropyridine calcium antagonist that has inhibito
ry actions on N-type as well as L-type voltage-dependent calcium channels,
has been reported to attenuate the cold stress-induced increase in plasma n
orepinephrine and BP in rats. Because white coat effect is associated with
an enhanced pressor response to mental stress, we postulated that cilnidipi
ne would attenuate white coat effect in patients with essential hypertensio
n.
Sixty-one consecutive outpatients (50 men, 11 women) with essential hyperte
nsion were studied prospectively. Twenty-nine patients were treated with ei
ther cilnidipine (n = 15) or nifedipine, a representative L-type voltage-de
pendent calcium antagonist (n = 14). Gender, age, body mass index, duration
of hypertension, target organ damage of hypertension, and BP and heart rat
e (HR) were not significantly different between cilnidipine and nifedipine
groups, and both systolic (SBP) and diastolic BP (DBP) were significantly d
ecreased after treatment in both groups. White coat effects on systolic and
DBP and HR were not significantly different between, groups before antihyp
ertensive treatment. Cilnidipine, but not nifedipine, significantly reduced
white coat effects on SBP and HR. Furthermore, white coat effects on systo
lic BP and HR were significantly lower after treatment in the cilnidipine g
roup compared with the nifedipine group. These data suggest that cilnidipin
e may reduce white coat effect in hypertensive patients by N-type calcium c
hannel antagonism. Am J Hypertens 2001;14:1053-1057 (C) 2001 American Journ
al of Hypertension, Ltd.