A clinical study on the anti-hypertensive effect of barnidipine HCl in hypertensive patients with renal disease

Background: Barnidipine is a new calcium channel blocker with a selective action on peripheral blood vessels. We investigated the efficacy and tolerability of barnidipine in the hypertensive patients with renal disease. Method: After a 4 week observation period, oral barnidipine 5 mg was administered. If blood pressure did not decrease to 149/89 mmHg or systolic and diastolic pressure did not decrease more than 20/10 mmHg from the baseline value, the dose of barnidipine was increased by 5 mg every 2 weeks. Blood pressure, heart rate and adverse effects were monitored every 2 weeks. We also assessed changes of renal function, serum electrolytes, uric acid, total cholesterol, liver function, 24 hours urine protein and sodium excretion and serum renin and aldosterone before and after barnidipine treatment in all patients. Results: Barnidipine reduced blood pressure from 158 ± 13.2/101.8 ± 7.1 mmHg to 139.9 ± 8.5/85.5 ± 7.5 mmHg (p<0.05). There were no significant changes in heart rate, renal function, daily urinary protein and sodium excretion, serum renin and aldosterone, serum electrolytes, uric acid and liver function test before and after barnidipine treatment. The elevation of total cholesterol and alkaline phosphatase was statistically significant, but this change was not significant clinically. Adverse effects of barnidipine were noted in 5 (16.7%) out of 30 patients. Facial flushing and palpitation were noted in 4 cases (13.3%) and headache was noted in 2 cases (6.7%). But their symptoms were mild and disappeared during treatment. Conclusion: In this study, we can conclude that barnidipine is a safe and effective calcium channel blocker for lowering blood pressure in hypertensive patients with renal disease. Further long-term and prospective clinical study would be needed to confirm our observations.