Lins Robert, Haerden Yves, de Vries Caroline
University of Antwerpen, Hazelarenstraat 7, Antwerpen, 2020, Belgium.
Astellas Pharma B.V., Brussels, Belgium.
High Blood Press Cardiovasc Prev. 2017 Mar;24(1):29-36. doi: 10.1007/s40292-016-0177-9.
Hypertension is the leading cause of cardiovascular disease worldwide. Calcium channel blockers are an effective antihypertensive treatment, but frequently hypertension remains uncontrolled for many patients, partly due to tolerability issues.
To assess the tolerability and effectiveness of barnidipine in mild to moderate hypertension patients switching treatment from other calcium channel blockers in daily practice.
BASIC-HT, a prospective real life study, enrolled 20,479 hypertensive patients initiating barnidipine treatment. The present paper focuses on a subgroup of patients in BASIC-HT for whom the previous treatment with amlodipine or lercanidipine was replaced by barnidipine. Tolerability and effectiveness of barnidipine in these patients were assessed at two visits during a 3-month follow up.
In 1710 mild to moderate hypertension patients switching treatment from amlodipine or lercanidipine to barnidipine monotherapy or in combination with other antihypertensive drug classes, mean blood pressure decreased during 3-month follow-up. The mean systolic blood pressure decreased from 153.15 mmHg [95% CI 152.35-153.95] at baseline to 139.20 mmHg [95% CI 138.58-139.82] at visit 3, after 3 months. The mean diastolic blood pressure decreased from 88.85 mmHg at baseline [95% CI 88.36-89.34], to 81.56 mmHg [95% CI 81.20-81.91] at visit 3. Among these patients, 65.4% replaced their initial calcium channel blocker treatment to barnidipine for tolerability reasons. During the follow-up, the main adverse event reported was edema (4.8%). The nature and frequency of events reported in this subgroup of switcher patients were in line with those reported by the total population in BASIC-HT.
This real-life study suggests that replacement of other calcium channel blockers with barnidipine is a valuable therapeutic option, especially when tolerability is an issue.
高血压是全球心血管疾病的主要病因。钙通道阻滞剂是一种有效的抗高血压治疗药物，但许多患者的高血压常常仍无法得到控制，部分原因是耐受性问题。
评估在日常实践中，巴尼地平对从其他钙通道阻滞剂转换治疗的轻至中度高血压患者的耐受性和有效性。
BASIC-HT是一项前瞻性现实生活研究，纳入了20479名开始接受巴尼地平治疗的高血压患者。本文重点关注BASIC-HT中一组患者，他们之前使用氨氯地平或乐卡地平的治疗被巴尼地平取代。在3个月的随访期间，对这些患者进行两次访视，评估巴尼地平的耐受性和有效性。
在1710名从氨氯地平或乐卡地平转换为巴尼地平单药治疗或与其他抗高血压药物联合治疗的轻至中度高血压患者中，3个月随访期间平均血压下降。3个月后，平均收缩压从基线时的153.15 mmHg[95%CI 152.35 - 153.95]降至第3次访视时的139.20 mmHg[95%CI 138.58 - 139.82]。平均舒张压从基线时的88.85 mmHg[95%CI 88.36 - 89.34]降至第3次访视时的81.56 mmHg[95%CI 81.20 - 81.91]。在这些患者中，65.4%因耐受性原因将初始钙通道阻滞剂治疗换成了巴尼地平。随访期间，报告的主要不良事件是水肿（4.8%）。该转换治疗患者亚组中报告的事件性质和频率与BASIC-HT总体人群报告的一致。
这项现实生活研究表明，用巴尼地平替代其他钙通道阻滞剂是一种有价值的治疗选择，尤其是在耐受性成为问题时。
