BACKGROUND & AIMS: AIM:The aim of this study was to determine the correlation of changes in left ventricular mass, with changes in office blood pressure (BP) and in 24-h ambulatory (ABP), with the trough-to-peak (T/P) ratio and with the smoothness index (SI), as induced by antihypertensive treatment with lercanidipine. METHODS:This was done through an observational, prospective, open, non-comparative, single centre, pilot study in patients naïve to antihypertensive therapy. All patients were treated with lercanidipine 10-20 mg/day plus hydrochlorothiazide 12.5-25 mg/day if treated BP exceeded an arbitrarily defined safety level (>160/100 mmHg) after 1 month on monotherapy. ABP monitoring was repeated after 1 month and after 6 months. Two-dimensional mode echocardiography was performed twice, at the beginning and end of the study. Seventeen patients were included in the final analysis (aged 45.8 +/- 10.7 years, 35% women). RESULTS:Treatment-induced changes in left ventricular mass index (LVMI) were not found to correlate neither with changes in office BP, with changes in ABP values, nor with T/P. However, a significant correlation was found between LVMI changes and SI at 6 months (r=0.50, P=0.039). CONCLUSION:The results of this study suggest that the SI has a higher predictive value, compared to other BP-derived parameters, for treatment-induced LVMI changes, in hypertensive patients treated with lercanidipine.

背景与目标： 目的：本研究的目的是确定左心室质量变化与办公室血压（BP）和24小时非卧床（ABP）变化与波峰（T / P）的相关性乐卡地平抗高血压治疗所致的比例和平滑度指数（SI）。
方法：这是通过一项观察性，前瞻性，开放性，非对照性，单中心，前瞻性研究对未接受降压治疗的患者进行的。如果在单药治疗1个月后，经治疗的BP超过任意定义的安全水平（> 160/100 mmHg），则所有患者均接受10-20 mg /天的乐卡地平加12.5-25 mg /天的氢氯噻嗪治疗。 1个月后和6个月后重复进行ABP监测。在研究开始和结束时，二维模式超声心动图检查进行了两次。最终分析包括17名患者（年龄45.8 / 10.7岁，女性35％）。
结果：未发现治疗引起的左心室质量指数（LVMI）的变化与办公室血压的变化，ABP值的变化或T / P均无关。然而，发现6个月时LVMI的变化与SI之间存在显着相关性（r = 0.50，P = 0.039）。
结论：本研究结果表明，与其他BP衍生参数相比，SI对接受lercanidipine治疗的高血压患者因治疗引起的LVMI变化具有更高的预测价值。

BACKGROUND & AIMS: :This double-blind, placebo-controlled, four-way balanced design crossover study included hypertensive patients aged 60-85 years with mean office-measured sitting systolic blood pressure (SBP) 160-179 mm Hg and daytime SBP > or =135 mm Hg. After a 2-week run-in period, during which previous medications were discontinued, each patient received the following four treatments in randomized order for 4 weeks each: lercanidipine 10 mg (L), enalapril 20 mg (E), lercanidipine 10 mg plus enalapril 20 mg (L/E) and placebo (P). At the end of each treatment period, office trough blood pressure (BP) was measured and a 24-h Ambulatory Blood Pressure Monitoring (ABPM) was performed. Seventy-five patients (mean age 66 years, office BP 168/92 mm Hg, daytime SBP 151 mm Hg) were randomized and 62 completed the study with four valid post-baseline ABPMs. The administration of P, L, E and L/E was associated with a mean 24-h SBP of 144, 137, 133 and 127 mm Hg, respectively. All active treatments significantly reduced the mean 24-h SBP in comparison with placebo, but L/E was significantly more effective than L and E alone. Similarly, office SBP was significantly more reduced with L/E (-16.9 mm Hg) than with L (-5.0 mm Hg) or E (-5.9 mm Hg). A BP <140/90 mm Hg was recorded in 18% of patients with L, 19% with E and 45% with L/E. Two patients on P and two on L/E were withdrawn from the study due to adverse events. In conclusion, combination therapy with L/E has additive antihypertensive effects on both ambulatory and office BP in elderly patients and is well tolerated.

背景与目标： ：这项双盲，安慰剂对照，四向平衡设计交叉研究纳入了60-85岁，平均办公室测量的坐位收缩压（SBP）160-179 mm Hg和白天SBP>或= 135 mm的高血压患者汞经过2周的磨合期（在此期间以前的药物已停止使用），每位患者随机接受以下4种治疗，每组4周：乐卡地平10 mg（L），依那普利20 mg（E），乐卡地平10 mg加依那普利20毫克（L / E）和安慰剂（P）。在每个治疗期结束时，测量办公室低谷血压（BP）并进行24小时动态血压监测（ABPM）。将75名患者（平均年龄66岁，办公室BP 168/92毫米汞柱，白天SBP 151毫米汞柱）随机分组，其中62名患者接受了四个有效的基线后ABPM来完成研究。施用P，L，E和L / E的平均24小时SBP分别为144、137、133和127 mm Hg。与安慰剂相比，所有积极治疗均显着降低了平均24小时SBP，但L / E比单独使用L和E更有效。同样，使用L / E（-16.9 mm Hg）的办公室SBP明显比使用L（-5.0 mm Hg）或E（-5.9 mm Hg）的办公室SBP减少更多。在18％的L患者，19％的E患者和45％的L​​ / E患者中记录到BP <140/90 mm Hg。由于不良事件，两名P病人和L / E病人两名退出研究。总之，L / E联合疗法对老年患者的门诊和办公室BP都有加成的降压作用，并且耐受性良好。

BACKGROUND & AIMS: OBJECTIVE:The aim of the present study was to compare the effects of the combination of lercanidipine/enalapril versus amlodipine/enalapril and hydrochlorothiazide/enalapril on blood pressure, target organ damage and sympathetic activation in patients with grade 2 essential hypertension. RESEARCH DESIGN AND METHODS:This was a 3 month, randomized, blinded-endpoint study in essential hypertensive patients. MAIN OUTCOME MEASURES:Office and ambulatory blood pressure, arterial stiffness, urinary albumin to creatinine ratio, renal arterial resistive index, and muscle sympathetic nerve activity were evaluated at baseline, after a 2 week run-in placebo period, at 1 month and at 3 months. RESULTS:In total, 56 patients were assigned to lercanidipine/enalapril (n = 19), enalapril/amlodipine (n = 18) and hydrochlorothiazide/enalapril (n = 19). Each pharmacological combination tested was effective in reducing office blood pressure at 1 month and 3 months, and 24 h ambulatory blood pressure at 3 months. Renal arterial resistive index (RI) significantly improved at 1 month and 3 months compared with baseline in all groups. However in the lercanidipine/enalapril and hydrochlorothiazide/enalapril groups, RI was favorably reduced (0.53 ± 0.03 and 0.54 ± 0.04 respectively, p < 0.05) in comparison with the enalapril/amlodipine RI value (0.57 ± 0.03) at 3 months. Moreover, after 3 months of treatment, a significant decrease (by -5.47 bursts/min) (p < 0.05) in muscle sympathetic nerve activity was observed in the lercanidipine/enalapril group (50.79 ± 6.49) compared with baseline (56.26 ± 6.05), while no differences were detected in the amlodipine/enalapril and hydrochlorothiazide/enalapril groups. CONCLUSIONS:Our study provides evidence of the efficacy of the lercanidipine/enalapril combination in ameliorating hypertension-related target organ damage and in reducing sympathetic overdrive.

背景与目标： 目的：本研究的目的是比较乐卡地平/依那普利与氨氯地平/依那普利和氢氯噻嗪/依那普利联用对2级原发性高血压患者血压，靶器官损害和交感神经活化的影响。
研究设计与方法：这是一项为期3个月的针对原发性高血压患者的随机，盲目的盲点研究。
主要观察指标：在基线期，磨合期2周，1个月和3个月后，在基线时评估办公室和门诊血压，动脉僵硬度，尿白蛋白与肌酐之比，肾动脉抵抗指数和肌肉交感神经活动。个月。
结果：总共56例患者被分配为lercanidipine / enalapril（n = 19），enalapril / amlodipine（n = 18）和hydrochlorothiazide / enalapril（n assigned = 19）。所测试的每种药理组合在1个月和3个月时均可有效降低办公室血压，在3个月时可降低24小时动态血压。在所有组中，与基线相比，肾动脉阻力指数（RI）在1个月和3个月时均显着改善。然而，在3个月时，与依那普利/氨氯地平RI值（0.57±0.03）相比，在lercanidipine / enalapril和hydrochlorothiazide / enalapril组中，RI有利地降低（分别为0.53±0.03和0.54±0.04，p <0.05）。此外，治疗3个月后，乐卡地平/依那普利组（50.79±6.49）与基线（56.26 nerve±6.05）相比，肌肉交感神经活动显着下降（-5.47次/分钟）（p <0.05）。 ，而氨氯地平/依那普利和氢氯噻嗪/依那普利组未见差异。
结论：我们的研究提供了乐卡地平/依那普利组合在减轻高血压相关靶器官损害和减少交感神经过度驱动方面的功效的证据。

BACKGROUND & AIMS: :Previous studies have demonstrated that lercanidipine, a calcium channel blocker, may protect against cardiac hypertrophy; however, the underlying mechanisms remain unclear. In the present study, the effects of lercanidipine on hypertrophy and the mechanisms involved were investigated. Cardiomyocytes isolated from neonatal rats were cultured and treated with angiotensin II (Ang II) in the presence or absence of lercanidipine or tacrolimus (FK506, a calcineurin inhibitor). Reverse transcription‑quantitative polymerase chain reaction was used to assess the mRNA expression of genes of interest, whereas the protein expression of calcium‑dependent signaling molecules was detected using western blot analysis. In addition, the cell surface area and the nuclear translocation of target proteins were evaluated using immunofluorescence. The results of the present study demonstrated that lercanidipine and FK506 inhibited Ang II‑induced cardiomyocyte hypertrophy, as evidenced by decreases in fetal gene (atrial natriuretic peptide and brain natriuretic peptide) expression levels and cell surface area. Notably, lercanidipine suppressed Ang II‑induced activation of calcineurin A (CnA) and nuclear factor of activated T cells 3 (NFAT3). In addition, calcium/calmodulin‑dependent kinase II (CaMKII)‑histone deacetylase 4 (HDAC4) signaling was also inhibited by lercanidipine. In conclusion, the present study demonstrated that lercanidipine may ameliorate cardiomyocyte hypertrophy, possibly partially by blocking Cn-NFAT3 and CaMKII-HDAC4 signaling.

背景与目标： ：以前的研究表明，钙通道阻滞剂来卡地平可以预防心肌肥大；但是，其潜在机制仍不清楚。在本研究中，研究了乐卡地平对肥大的影响及其涉及的机制。培养分离自新生大鼠的心肌细胞，并在存在或不存在lercanidipine或他克莫司（钙调神经磷酸酶抑制剂FK506）的情况下，用血管紧张素II（Ang II）对其进行处理。逆转录定量聚合酶链反应用于评估目的基因的mRNA表达，而钙依赖性信号分子的蛋白质表达则通过蛋白质印迹分析进行检测。另外，使用免疫荧光评估靶蛋白的细胞表面积和核易位。本研究的结果表明，lercanidipine和FK506抑制了Ang II诱导的心肌肥大，胎儿基因（心钠素和脑钠素）表达水平和细胞表面积的降低证明了这一点。值得注意的是，lercanidipine抑制了Ang II诱导的钙调神经磷酸酶A（CnA）活化和活化T细胞3（NFAT3）的核因子。此外，lercanidipine还抑制钙/钙调蛋白依赖性激酶II（CaMKII）-组蛋白脱乙酰基酶4（HDAC4）信号传导。总之，本研究表明，lercanidipine可能改善心肌细胞肥大，可能部分地通过阻断Cn-NFAT3和CaMKII-HDAC4信号传导来改善。

BACKGROUND & AIMS: :The review describes the classification, mechanisms of action, the effects of calcium channel blockers slow and the clinical benefits of dihydropyridine calcium antagonists, the third generation. Presented modern aspects of clinical pharmacology and research results on the efficacy, safety and organoprotective lercanidipine.

背景与目标： ：该综述描述了第三代药物的分类，作用机理，钙通道阻滞剂的作用缓慢以及二氢吡啶类钙拮抗剂的临床益处。介绍了临床药理学的现代方面以及功效，安全性和有机保护性乐卡地平的研究成果。

BACKGROUND & AIMS: BACKGROUND:The relationship between oxidative stress, lipoproteins, cardiovascular risk factors and vascular disease progression has recently attracted fresh attention due to the possibility of measuring free radicals (FRs). The aim of this study was to evaluate blood plasma variations in oxygen FRs in hypertensive patients treated with lercanidipine, a drug acting on blood pressure and microcirculation. METHODS:Twenty-two patients with moderate hypertension (M:F=12:10; age=52) and no vascular disease (evaluated by high-resolution ultrasound) were treated for 24 weeks with Lercanidipine (10 mg/day or 20 mg/day if BP values did not decrease at least 15 percent after four weeks of treatment). BP was measured at inclusion and after 4, 8, 12 and 24 weeks of treatment. FRs measurements (using the D-Roms test) were made at inclusion, at the 8th, 12th and 24th week. RESULTS:All patients completed the treatment which was well tolerated and without side effects. Systolic and diastolic BP decreased after 8, 12 (p<0.05) and 24 weeks (at 24 weeks systolic pressure was decreased by 21.1 percent, and diastolic by 11.1 percent; p<0.02). FRs levels progressively decreased from 541 Carr Units (SD 54) at inclusion to 411 (SD 56) at eight weeks (p<0.05), to 401 (SD 35) (p<0.05) at 12 weeks and finally to 398 (SD 33), (p<0.02) at 24 weeks of treatment (72.2 percent of the initial value). CONCLUSIONS:The possibility of measuring FRs in vivo with a simple, inexpensive test allows the identification of subjects with a high level of oxidative stress, and the monitoring of the effects of treatments. Lercanidipine, acting on blood pressure, on the microcirculation and decreasing oxidative stress and Frs plasma levels may effectively decrease the rate of progression of cardiovascular diseases offering the advantage of an increased level of protection in patients with high levels of oxidative stress.

背景与目标： 背景：氧化应激，脂蛋白，心血管危险因素和血管疾病进展之间的关系由于可以测量自由基（FRs）的可能性，最近引起了新的关注。这项研究的目的是评估用来卡地平（一种作用于血压和微循环的药物）治疗的高血压患者的血浆血浆氧FRs变化。
方法：对22例中度高血压患者（M：F = 12：10；年龄= 52）且无血管疾病（通过高分辨率超声评估）用乐卡地平（10 mg /天或20 mg /天）治疗24周如果在治疗4周后血压值未至少降低15％，则为一天）。在入选时以及治疗4、8、12和24周后测量BP。 FRs测量（使用D-Roms测试）是在第8、12和24周时进行的。
结果：所有患者均完成了治疗，耐受性良好，无副作用。收缩压和舒张压在第8、12（p <0.05）和24周后降低（p <0.05），在第24周时，收缩压降低了21.1％，舒张压降低了11.1％； p <0.02。 FRs水平从入组时的541 Carr Units（SD 54）逐渐降低至第8周的411（SD 56）（p <0.05），第12周的401（SD 35）（p <0.05），最后降至398（SD 33） ），在治疗24周时（p <0.02）（初始值的72.2％）。
结论：通过简单，廉价的测试方法可以在体内测量FRs，从而可以鉴定出氧化应激水平高的受试者，并监测治疗效果。乐卡地平对血压起作用，作用于微循环并降低氧化应激和Frs血浆水平，可有效降低心血管疾病的进展速度，具有在氧化应激水平高的患者中提高保护水平的优势。

BACKGROUND & AIMS: OBJECTIVE:Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers. DESIGN AND METHODS:The study included 68 proteinuric (> 500 mg/day) patients (age 63.1 +/- 12.9 years, 69.1% males and 30.9 females). All patients were receiving ACE inhibitors (51.4%) or angiotensin II receptor blockers (48.6%) therapy but had higher blood pressure than recommended for proteinuric patients (<130/80 mmHg). Patients were clinically evaluated one, three, and six months after starting treatment with lercanidipine (20 mg/day). Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment. Creatinine clearance was measured using 24 h urine collection. RESULTS:BP significantly decreases from 152 +/- 15/86 +/- 11 mmHg to 135 +/- 12/77 +/- 10 mmHg at six months of follow-up (p < 0.001). After six months of treatment, the percentage of normalized patients (BP < 130/80 mmHg) was 42.5%, and the proportion of patients whose BP was below 140/90 mmHg was 58.8%. Plasmatic creatinine did not change nor did creatinine clearance. Plasmatic cholesterol also decreased from 210 +/- 48 to 192 +/- 34 mg/dL (p < 0.001), as did plasma triglycerides (from 151 +/- 77 to 134 +/- 72 mg/dL, p = 0.022). Basal proteinuria was 1.63 +/- 1.34 g/day; it was significantly (p < 0.001) reduced by 23% at the first month, 37% at three months, and 33% at the last visit. CONCLUSIONS:Lercanidipine at 20 mg dose, associated to renin-angiotensin axis-blocking drugs, showed a high antihypertensive and antiproteinuric effect. This antiproteinuric effect seems to be dose-dependent as compared with previous reports and proportionally higher than blood pressure reduction.

背景与目标： 目的：大多数钙拮抗剂似乎并未减少微量白蛋白尿或蛋白尿。我们已尝试评估钙通道阻滞剂lercanidipine在先前使用ACE抑制剂或血管紧张素受体阻滞剂治疗的患者中的抗蛋白尿作用。
设计与方法：该研究包括68位蛋白尿（> 500 mg /天）患者（年龄63.1 /-12.9岁，男性69.1％，女性30.9）。所有患者均接受ACE抑制剂（51.4％）或血管紧张素II受体阻滞剂（48.6％）治疗，但血压高于蛋白尿患者推荐的血压（<130/80 mmHg）。在开始使用lercanidipine（20 mg / day）治疗后的一个月，三个月和六个月，对患者进行了临床评估。在检查过程中采集了尿液和血液检查样本。需要时，将第三种药物添加到治疗中。使用24小时尿液收集测定肌酐清除率。
结果：在六个月的随访中，BP显着降低，从152 /-15/86 /-11 mmHg降至135 /-12/77 /-10 mmHg（p <0.001）。治疗六个月后，正常患者（BP <130/80 mmHg）的百分比为42.5％，血压低于140/90 mmHg的患者比例为58.8％。血浆肌酐没有改变，肌酐清除率也没有改变。血浆胆固醇也从210 /-48降至192 /-34 mg / dL（p <0.001），血浆甘油三酸酯也从151 /-77降至134 /-72 mg / dL，p = 0.022。基础蛋白尿为1.63 / 1.34 g /天；第一个月显着降低（p <0.001），三个月降低37％，最后一次访视降低33％（p <0.001）。
结论：20mg剂量的Lercanidipine与肾素-血管紧张素轴阻滞药物有关，具有较高的抗高血压和抗蛋白尿作用。与以前的报道相比，这种抗蛋白尿作用似乎是剂量依赖性的，并且比降血压成比例地更高。

BACKGROUND & AIMS: :We evaluated the antiischemic action and the effects on left ventricular response to exercise of lercanidipine, a long-acting dihydropyridine calcium antagonist, in 23 patients with stable effort angina in a randomized, double-blind, parallel trial. Left ventricular function was assessed during upright bicycle exercise using an ambulatory radionuclide detector for continuous noninvasive monitoring of cardiac function. Exercise was performed under control conditions before (run-in placebo period) and after 2-week treatment with lercanidipine 10 or 20 mg once daily. During the placebo run-in period and at the study end, patients underwent clinical examination, ECG, exercise tests, ambulatory ventricular scintigraphic monitoring (VEST). Results showed that both drug doses increased time to onset of ST segment depression >/=1 mm and peak ST segment depression, with improvement of total exercise duration. Heart rate, blood pressure, and the rate-pressure product did not significantly change with respect to pretreatment value. The left ventricular ejection fraction, indicating contractility state of myocardium, was unchanged at rest and during exercise after both lercanidipine doses. In conclusion, lercanidipine is safe and effective in reducing ischemia in patients with stable effort angina without any deterioration of cardiac function.

背景与目标： ：我们在一项随机，双盲，平行试验中评估了23名稳定努力型心绞痛患者的抗缺血作用以及对长效二氢吡啶类钙拮抗剂lercanidipine运动的左心室反应的影响。在直立式自行车运动过程中，使用可移动的放射性核素检测仪对左心室功能进行评估，以连续无创监测心功能。在控制条件下（磨合安慰剂时期）和每天两次接受lercanidipine 10或20 mg治疗2周后，在控制条件下进行运动。在安慰剂试验期间和研究结束时，患者接受临床检查，心电图，运动测试，动态心室闪烁显像（VEST）。结果表明，两种药物剂量均增加了ST段压低> / = 1 mm的发作时间和ST段压低的峰值，并改善了总运动时间。心率，血压和心率乘积相对于预处理值没有显着变化。两种雷卡地平剂量后，静息和运动期间左心室射血分数均表示心肌的收缩状态。总之，乐卡地平对稳定努力型心绞痛的患者而言，安全有效地减少缺血，而心脏功能没有任何恶化。

BACKGROUND & AIMS: OBJECTIVES:Lipoprotein oxidation, dyslipidemia, and hypertension are important underlying causes of accelerated atherosclerosis in patients with diabetes mellitus. The potential of antihypertensive medications to reduce lipid oxidation is, therefore, an important determinant in the choice of agents for patients with diabetes mellitus. The aim of this study was to compare the lowering effect of a new dihydropyridine calcium antagonist, lercanidipine, with that of the first angiotensin-receptor blocker, losartan, on low-density lipoprotein (LDL) oxidation. METHODS:Forty patients in metabolically stable condition who had type 2 diabetes mellitus with hypertension were studied in this single-blind, randomized, prospective crossover study, comprising 2 treatment periods of 16 weeks each, separated by a 4-week washout period. LDL oxidation was evaluated by dialdehyde analysis by means of the thiobarbituric acid-reactive substances assay with and without cupric sulfate, as well as determination of conjugated dienes in the LDL lipid extract. RESULTS:Lercanidipine and losartan both significantly reduced the propensity of the serum to oxidize LDL (P =.001). With one method of estimation (conjugated dienes), the effect of lercanidipine was superior to that of losartan (P =.04). Losartan lowered urinary albumin excretion but lercanidipine did not. CONCLUSIONS:Both lercanidipine and losartan attenuate LDL oxidation in patients with type 2 diabetes mellitus and hypertension. This observation may offer insight into the mechanisms of the therapeutic effects of these agents in patients with diabetes mellitus.

背景与目标： 目的：脂蛋白氧化，血脂异常和高血压是糖尿病患者加速动脉粥样硬化的重要根本原因。因此，降压药减少脂质氧化的潜力是选择糖尿病患者用药的重要决定因素。这项研究的目的是比较一种新型的二氢吡啶类钙拮抗剂lercanidipine和第一种血管紧张素受体阻滞剂losartan对低密度脂蛋白（LDL）氧化的降低作用。
方法：在这项单盲，随机，前瞻性交叉研究中，对40名代谢稳定状态的2型糖尿病合并高血压患者进行了研究，该研究包括2个治疗期，每个治疗期16周，相隔4周的清除期。 LDL的氧化通过二醛分析来评估，方法是在有或没有硫酸铜的情况下，通过硫代巴比妥酸反应性物质测定，以及测定LDL脂质提取物中的共轭二烯。
结果：乐卡地平和氯沙坦均显着降低了血清氧化低密度脂蛋白的倾向（P = .001）。用一种估计方法（共轭二烯），乐卡地平的作用优于氯沙坦（P = .04）。氯沙坦可降低尿白蛋白排泄量，而乐卡地平则不能。
结论：lercanidipine和losartan均可减轻2型糖尿病和高血压患者的LDL氧化。该观察结果可以提供对这些药物对糖尿病患者的治疗作用机理的见解。

BACKGROUND & AIMS: :The aim of this study was to evaluate the macrocirculatory and microcirculatory effects of treatment with lercanidipine, a new antihypertensive agent acting both on blood pressure and microcirculation in patients with moderate essential hypertension and without vascular disease and in patient with hypertension and vascular disease. In hypertensive subjects target-organ damage associated with high blood pressure may now be objectively documented by noninvasive tests. These alterations constitute a model to evaluate not only the pressure effects of antihypertensive treatment but also the normalization of the peripheral microcirculatory network. With color duplex scanning, flow velocity in the central retinal artery and retinal flow velocity can be measured and with use of laser-Doppler-flowmetry, it is also possible to evaluate microcirculation alterations in hypertensive subjects. These evaluation methods are completely noninvasive and may be used to assess the microcirculatory effects of antihypertensive drugs.

背景与目标： ：本研究的目的是评估在患有中度原发性高血压和无血管疾病的患者以及患有高血压和血管疾病的患者中，使用新的降压药lercanidipine治疗大环和微循环的作用。在高血压受试者中，与高血压相关的靶器官损害现在可以通过非侵入性测试客观记录。这些改变构成了一个模型，不仅可以评估降压治疗的压力效果，还可以评估周围微循环网络的正常化。通过彩色双工扫描，可以测量视网膜中央动脉的流速和视网膜流速，并且通过使用激光多普勒血流仪，还可以评估高血压患者的微循环改变。这些评估方法完全是非侵入性的，可用于评估降压药的微循环作用。

BACKGROUND & AIMS: BACKGROUND:Combination therapy is an effective method to reduce the blood pressure (BP) for patients with hypertension. This study was performed to evaluate the efficacy and safety of benazepril/lercanidipine compared with benazepril alone in patients with mild-to-moderate hypertension. METHODS:One hundred and eighty-one patients with mild-to-moderate primary hypertension were assigned in this randomized, single-blind, parallel-group study and were randomly divided into group A (benazepril 10 mg/lercanidipine 10 mg) and group B (benazepril 10 mg) for 8 weeks. At 4 weeks, the dosage of Benazepril was titrated up to 20 mg if the diastolic blood pressure (DBP) remained ≥ 90 mmHg. BP control and side effects were evaluated at the end of 1, 4 and 8 weeks. RESULTS:The baseline characteristics of the two groups were similar. The BP in both groups decreased from the baseline (P < 0.05). At the end of 4 and 8 weeks, Benazepril/Lercanidipine produced greater BP reduction than Benazepril alone (P < 0.05). The comparison of the rate of BP control for the benazepril/lercanidipine and benazepril groups at the end of 1, 4, and 8 weeks were 41.2% vs. 37.6% (P > 0.05), 67.1% vs. 44.7% (P < 0.05), and 71.8% vs. 45.9% (P < 0.05). There was no significant difference of side effects between the two groups. CONCLUSION:The benazepril/lercanidipine combination is more effective in reducing BP than benazepril alone, while it does not increase the incidence of side effects.

背景与目标： 背景：联合治疗是降低高血压患者血压的有效方法。本研究旨在评估贝那普利/雷卡地平与轻度至中度高血压患者相比单独使用贝那普利的疗效和安全性。
方法：118例轻度至中度原发性高血压患者被纳入这项随机，单盲，平行组研究，并随机分为A组（苯那普利10 mg / lercanidipine 10 mg）和B组（苯那普利10毫克）持续8周。如果舒张压（DBP）保持≥90 mmHg，则在4周时将贝那普利的剂量最高滴定至20 mg。在第1、4和8周结束时评估血压控制和副作用。
结果：两组的基线特征相似。两组的血压均较基线下降（P <0.05）。在第4和第8周结束时，贝那普利/来那地平产生的BP降低量大于单独的贝那普利（P <0.05）。在第1、4和8周结束时，贝那普利/雷卡地平和贝那普利组的BP控制率比较分别为41.2％vs. 37.6％（P> 0.05），67.1％vs. 44.7％（P <0.05 ），分别为71.8％和45.9％（P <0.05）。两组之间的副作用没有显着差异。
结论：贝那普利/雷卡地平联合用药比单独使用贝那普利更能有效降低血压，但不会增加副作用的发生率。

BACKGROUND & AIMS: BACKGROUND:Irrespective of their clinical relevance, side effects cannot be considered a negligible problem in antihypertensive therapy. The aim of this trial was to evaluate the tolerability profile of lercanidipine with that of two other calcium antagonists (amlodipine and lacidipine) in elderly hypertensives. METHODS:In a multicenter, double-blind, parallel study 828 elderly (aged > or =60 years) hypertensives were randomized to lercanidipine 10 mg/day (n = 420), amlodipine 5 mg/day (n = 200), or lacidipine 2 mg/day (n = 208) (ratio 2:1:1). If blood pressure (BP) control was unsatisfactory (systolic BP/diastolic BP > or =140/90 mm Hg), the dose of the double-blind medication was doubled and, as a further step, enalapril or atenolol (plus diuretic, if needed) was added. Patients were treated for an average of 12 months. RESULTS:Amlodipine patients had significantly (P <.001) higher rates of edema (19%) and of early study discontinuations due to edema (8.5%) compared with lercanidipine (9% and 2.1%) and lacidipine patients (4% and 1.4%). Similarly, edema-related symptoms (lower limb swelling and heaviness) occurred significantly (P <.01) more often with amlodipine (50% and 45%, respectively) than with lercanidipine (35% and 33%) and lacidipine (34% and 31%). Most edema cases occurred in the first 6 months, a between-treatment difference being evident since beginning of treatment. Other drug-related adverse events did not differ between treatments. Blood pressure was equally and effectively reduced in the three groups. CONCLUSIONS:The two lipophilic dihydropyridine calcium antagonists, lercanidipine and lacidipine, have an antihypertensive effect comparable to that of amlodipine, but a better tolerability profile.

背景与目标： 背景：无论其临床意义如何，在高血压治疗中副作用都不能被认为是可以忽略不计的问题。该试验的目的是评估乐卡地平与其他两种钙拮抗剂（氨氯地平和拉西地平）在老年高血压患者中的耐受性。
方法：在一项多中心，双盲，平行研究中，将828名老年（年龄≥60岁）高血压患者随机分为乐卡地平10 mg /天（n = 420），氨氯地平5 mg /天（n = 200）或拉西地平2毫克/天（n = 208）（比例2：1：1）。如果血压（BP）的控制效果不理想（收缩压/舒张压BP>或= 140/90 mm Hg），则双盲药物的剂量应加倍，作为进一步措施，使用依那普利或阿替洛尔（如果需要则加利尿剂）需要）添加。患者平均接受治疗12个月。
结果：与乐卡地平（9％和2.1％）和拉西地平患者（4％和1.4）相比，氨氯地平患者的水肿发生率（19％）和因水肿而导致的早期研究中断（8.5％）显着（P <.001） ％）。同样，氨氯地平（分别为50％和45％）比乐卡地平（35％和33％）和拉西地平（34％和40％ 31％）。大多数水肿病例发生在头6个月，自治疗开始以来，治疗之间存在明显差异。其他药物相关的不良事件在治疗之间没有差异。在三组中，血压均被有效地降低。
结论：两种亲脂性二氢吡啶类钙拮抗剂乐卡地平和拉西地平具有与氨氯地平相当的降压作用，但耐受性较好。

BACKGROUND & AIMS: :The influence of treatment with the dihydropyridine-type Ca2+ antagonist lercanidipine on heart and coronary microanatomic changes was investigated in spontaneously hypertensive rats, Cohen-diabetic rats, and Cohen-Rosenthal diabetic hypertensive rats. At 12 weeks of age, animals were left untreated (control groups) or were treated for 8 weeks with an oral dose of 3 mg/kg per day of lercanidipine. Wistar-Kyoto rats were used as a normotensive reference group. In spontaneously hypertensive rats and diabetic hypertensive rats, systolic blood pressure was higher in comparison with Wistar-Kyoto rats. Augmented pressure values were decreased by lercanidipine treatment. Systolic blood pressure was slightly higher in Cohen-diabetic rats than in Wistar-Kyoto rats, and this increase was countered by treatment with lercanidipine. In spontaneously hypertensive rats, diabetic rats, and diabetic hypertensive rats, the thickness of left ventricle and cardiocyte area were increased. Focal connective tissue areas and diffuse accumulation of connective tissue were observed in the left ventricle of spontaneously hypertensive and Cohen-diabetic rats, respectively. Pharmacological treatment countered left ventricle thickening and restored cardiocyte area values in subendocardium. An increased thickness of tunica media accompanied by luminal narrowing was found in coronary artery branches of control spontaneously hypertensive and diabetic hypertensive rats. Treatment with lercanidipine countered vascular changes primarily in small-sized coronary arteries. These results indicate that hypertensive, diabetic, and diabetic hypertensive rats undergo cardiac hypertrophy and vascular changes affecting small-sized coronary arteries. Treatment with lercanidipine countered hypertension-related cardiac and coronary changes, suggesting that this dihydropyridine-type Ca2+ antagonist may improve heart and coronary structure in diabetes associated with hypertension.

背景与目标： ：在自发性高血压大鼠，Cohen-糖尿病大鼠和Cohen-Rosenthal糖尿病高血压大鼠中，研究了用二氢吡啶类Ca2拮抗剂乐卡地平治疗对心脏和冠状动脉微解剖学变化的影响。在12周大时，动物不予治疗（对照组）或以每天3 mg / kg的lercanidipine口服剂量治疗8周。 Wistar-Kyoto大鼠用作血压正常对照组。与Wistar-Kyoto大鼠相比，自发性高血压大鼠和糖尿病性高血压大鼠的收缩压更高。乐卡地平治疗可增加压力值。 Cohen-糖尿病大鼠的收缩压略高于Wistar-Kyoto大鼠，而这种增加可以通过用lercanidipine治疗来抵消。在自发性高血压大鼠，糖尿病大鼠和糖尿病性高血压大鼠中，左心室厚度和心肌细胞面积增加。自发性高血压和科恩-糖尿病大鼠的左心室分别观察到局灶性结缔组织区域和结缔组织的弥漫性积聚。药物治疗可抵抗心内膜下左心室增厚和恢复心肌细胞面积值。在自发性高血压和糖尿病性高血压大鼠的冠状动脉分支中发现中膜厚度增加并伴有腔狭窄。乐卡地平的治疗主要在小型冠状动脉中抵抗血管变化。这些结果表明，高血压，糖尿病和糖尿病高血压大鼠经历心脏肥大和血管变化，影响了小冠状动脉。乐卡地平的治疗可对抗高血压相关的心脏和冠状动脉变化，提示这种二氢吡啶类Ca2拮抗剂可改善与高血压相关的糖尿病患者的心脏和冠状动脉结构。

BACKGROUND & AIMS: OBJECTIVE:The RED LEVEL study (REnal Disease: LErcanidipine Valuable Effect on urine protein Losses) directly compares, in an explorative fashion, the effects of lercanidipine + enalapril and amlodipine + enalapril combinations on renal parameters in hypertensive subjects. RESEARCH DESIGN AND METHODS:This was a 1 year, prospective, multi-center, randomized, open-label, blinded-endpoint (PROBE) study in hypertensive patients with albuminuria. MAIN OUTCOME MEASURES:Renal function (albuminuria, serum creatinine, creatinine clearance, estimated glomerular filtration rate and proteinuria); blood pressure. RESULTS:Albuminuria was significantly reduced, compared with baseline values, with the lercanidipine + enalapril combination over the entire study period; at month 3, month 6 and month 12, changes from baseline were: -162.5 (p-value = 0.0439), -425.8 (p-value = 0.0010), -329.0 (p-value = 0.0011) mg/24 h), respectively. On the other hand, this improvement was not observed with enalapril + amlodipine. Other parameters of renal function such as serum creatinine, creatinine clearance, estimated glomerular filtration rate and proteinuria did not change over the study. Both lercanidipine + enalapril and amlodipine + enalapril significantly reduced systolic and diastolic blood pressure values from baseline all over the study period with no significant differences between groups. Safety outcomes were comparable between the two groups. CONCLUSIONS:Overall, the results of this explorative study lend support to the anti-albuminuric effect of the lercanidipine + enalapril combination and to the long term renal-protective effects of this combination in patients with hypertension.

背景与目标： 目的：RED LEVEL研究（肾病：乐卡地平对尿蛋白损失的重要作用）以探索性方式直接比较了乐卡地平那拉普利和氨氯地平那拉普利组合对高血压受试者肾脏参数的影响。
研究设计与方法：这是一项针对高血压蛋白尿患者的为期1年的前瞻性，多中心，随机，开放标签，盲点（PROBE）研究。
主要观察指标：肾功能（白蛋白尿，血清肌酐，肌酐清除率，估计的肾小球滤过率和蛋白尿）；血压。
结果：在整个研究期间，使用lercanidipine®enalapril联合用药，与基线值相比，白蛋白尿明显减少；在第3个月，第6个月和第12个月时，与基线相比的变化为：-162.5（p值== 0.0439），-425.8（p值= 0.0010），-329.0（p值= 0.0011）mg / 24 h，分别。另一方面，依那普利氨氯地平未观察到这种改善。在本研究中，其他肾功能参数，例如血清肌酐，肌酐清除率，估计的肾小球滤过率和蛋白尿均未改变。在整个研究期间，lercanidipine enalapril和amlodipine enalapril均较基线显着降低了收缩压和舒张压值，各组之间无显着差异。两组的安全性结果可比。
结论：总的来说，这项探索性研究的结果为乐卡地平那那普利组合的抗白蛋白尿作用以及该组合对高血压患者的长期肾脏保护作用提供了支持。

BACKGROUND & AIMS: :This randomised, double-blind, double-dummy, parallel group, multicentre study compared the efficacy and tolerability of lercanidipine with lacidipine. Elderly patients with isolated systolic hypertension (supine blood pressure >/=160/<95 mmHg) were enrolled and underwent a placebo run-in period of 14-27 days before random allocation to lercanidipine tablets 10 mg once daily (n=111) or lacidipine tablets 2 mg once daily (n=111) for the assessment period (112-160 days). Titration to lercanidipine 20 mg once daily (two 10 mg tablets) or lacidipine 4 mg once daily (two 2 mg tablets) was allowed after 8 weeks, if required. Both treatments decreased supine and standing systolic and diastolic blood pressure between the end of the run-in period and the end of the assessment period (P<0.0001). At the end of the assessment period, the estimated mean treatment difference (95% confidence intervals) in supine systolic blood pressure was -0.81 (-4.45, 2.84) mmHg. These confidence intervals were within the limits specified for equivalence, that is, (-5, 5) mmHg. Ambulatory blood pressure monitoring showed that the antihypertensive effects of both drugs lasted for the full 24-h dosing period and followed a circadian pattern. Both treatments were well tolerated with a low incidence of adverse drug reactions and a low withdrawal rate. Significantly fewer patients withdrew from treatment with lercanidipine (P=0.015). Neither treatment had any clinically significant effect on pulse rate or cardiac conduction. In conclusion, both treatments were equally effective in controlling supine systolic blood pressure in patients with isolated systolic hypertension.

背景与目标： ：这项随机，双盲，双虚拟，平行组，多中心研究比较了乐卡地平和拉西地平的疗效和耐受性。入选了患有单纯收缩期高血压（仰卧血压> / = 160 / <95 mmHg）的老年患者，并进行了14-27天的安慰剂磨合期，然后每天随机分配一次10 mg lercanidipine片（n = 111）或拉西平片2 mg每天一次（n = 111），用于评估期（112-160天）。如果需要，允许在8周后滴定至每天20 mg乐卡地平（两次10 mg片剂）或lacidipine 4 mg每天滴定（两次2 mg片剂）滴定。在磨合期结束和评估期结束之间，两种治疗均降低了仰卧位和站立时的收缩压和舒张压（P <0.0001）。在评估期结束时，仰卧收缩压的估计平均治疗差异（95％置信区间）为-0.81（-4.45，2.84）mmHg。这些置信区间在等效的指定限制内​​，即（-5，5）mmHg。动态血压监测表明，这两种药物的降压作用持续了整个24小时的服药期间，并遵循了昼夜节律模式。两种疗法均具有良好的耐受性，药物不良反应发生率低，停药率低。乐卡地平退出治疗的患者明显减少（P = 0.015）。两种疗法均未对脉搏率或心脏传导产生任何临床显着影响。总之，两种治疗方法在控制单纯收缩期高血压患者的仰卧收缩压方面均有效。