Effects of the long-acting calcium channel blocker barnidipine hydrochloride on 24-h ambulatory blood pressure: Results of the Japanese Multicenter Study on Barnidipine with Ambulatory Blood Pressure Monitoring

The effect of barnidipine hydrochloride (barnidipine) on 24-h ambulatory blood pressure (ABP) was evaluated based on the results of Japanese Multicenter Study on Barnidipine with Ambulatory Blood Pressure Monitoring (J-MUBA). Barnidipine decreased outpatient clinic blood pressure and ABP in 387 patients, but did not affect heart rate. The patients were divided into high- and low-range groups based on ABP measurement. Barnidipine exerted an antihypertensive effect throughout the 24-h monitoring period in the high-range group, but not in the low-range group. Barnidipine had comparable effects in the daytime and night-time in inverted dippers and non-dippers, but it had more effect on daytime ABP than on night-time ABP in dippers. In extreme dippers, barnidipine markedly decreased high daytime ABP, but not low night-time ABP. Morning blood pressure before and after waking was evaluated before and after barnidipine administration in 233 patients. Barnidipine inhibited increases in blood pressure before and after waking, especially in surge-type patients whose blood pressure increased rapidly after waking. A positive correlation among 24-h, daytime, and night-time ABP, morning blood pressure, and outpatient clinic blood pressure during the observation period and the antihypertensive effect of barnidipine was observed, with barnidipine exhibiting stronger antihypertensive effects in patients with persistently high blood pressure. In conclusion, these results indicate that the antihypertensive effects of barnidipine are maintained for 24 h but it has no excessive hypotensive effects on lower blood pressure and is thus a safe antihypertensive agent.