Beneficial Effect of Efonidipine, an L- and T-Type Dual Calcium Channel Blocker, on Heart Rate and Blood Pressure in Patients With Mild-to-Moderate Essential Hypertension

Background and Objectives: Efonidipine hydrochloride, an L- and T-type dual calcium channel blocker, is suggested to have a heart rate (HR)-slowing action in addition to a blood pressure (BP)-lowering effect. The aim of this study was to determine the effect of efonidipine on HR and BP in patients with mild-to-moderate hypertension. Subjects and Methods: In a multi-center, prospective, open-labeled, single-armed study, we enrolled 53 patients who had mild-to-moderate hypertension {sitting diastolic BP (SiDBP) 90-110 mmHg}. After a 2-week washout, eligible patients were treated with efonidipine (40 mg once daily for 12 weeks). The primary end point was the change in HR from baseline to week 12. The secondary endpoint included the change in trough sitting BP and 24-hour mean BP between baseline and week 12. Laboratory and clinical adverse events were monitored at each study visit (4, 8, and 12 weeks). Results: Fifty-two patients were included in the inten-tion-to-treat analysis. After 12 weeks of treatment with efonidipine, the resting HR decreased significantly from baseline to week 12 {from 81.5${\pm}$5.3 to 71.8${\pm}$9.9 beats/minute (difference, -9.9${\pm}$9.0 beats/minute), p<0.0001}. The trough BP {sitting systolic blood pressure (SiSBP) and SiDBP} and 24-hour mean BP also decreased significantly (SiSBP: from 144.6${\pm}$8.2 to 132.9${\pm}$13.5 mmHg, p<0.0001; SiDBP: from 96.9${\pm}$5.4 to 88.3${\pm}$8.6 mmHg, p<0.0001, 24-hour mean systolic BP: from 140.4${\pm}$13.5 to 133.8${\pm}$11.6 mmHg, p<0.0001; 24-hour mean diastolic BP: from 91.7${\pm}$8.7 to 87.5${\pm}$9.5 mmHg, p<0.0001). Con-clusion: Efonidipine was effective in controlling both HR and BP in patients with mild-to-moderate hypertension.