The Promise of Cilnidipine in Hypertension with Comorbidities: National Consensus Statement: National Consensus Group Comprises Cardiologists, Nephrologists, and Diabetologists from India in a National Meet at New Delhi held on 22 May 2022.
Asha Moorthy, Gurpreet S Wander, Chandrashekhar K Ponde, Hirday Kumar Chopra, D S Rana, R R Kasliwal, Rabin Chakraborty, Viveka Kumar, Arvind K Pancholia, Vishal Rastogi, Y K Arora, Mohan Bhargava, Aparna Jaswal, Ashok K Omar, Dilip Bhalla, I B Vijayalakshmi, Sandeep Bansal, Harmohander S Isser, S S Mishra, Vivek Tandon, Ajay Sinha, Praveen Jain, Ramesh Hotchandani, V K Katyal, Sanjiv Gulati, Rohit Tandon, Blessy Sehgal, Vitull Gupta, S N Pathak, M S Yadav, N R Shastry, Rahul Mehrotra, Kartikeya Bhargava, Dinesh Khullar, Narendra Nath Khanna, Rajeev Chawla, Shalini Jaggi, Rajiv Passey, K Venugopal, Nandini Chatterjee, Jyotirmoy Pal, Satyanarayan Routray, Sunil Prakash, Arup Dasbiswas, Praveen Chandra, Aditya Kapoor, Jabir Abdullakutty, Anil Saxena, Jps Sawhney, N C Krishnamani, Saumitra Ray, Vinod Sharma, Dharmendra Jain, Tiny Nair, Vijay Kher, Manish Bansal, Mangesh Tiwaskar, Shambo Samrat Samajdar, Anil Kumar Bhalla, Mona Bhatia, Navin C Nanda
Journal: The Journal of the Association of Physicians of India
2024;72(1):88-95
PMID: 38736080
Abstract
The rapidly increasing burden of hypertension is responsible for premature deaths from cardiovascular disease (CVD), renal disease, and stroke, with a tremendous public health and financial burden. Hypertension detection, treatment, and control vary worldwide; it is still low, particularly in low- and middle-income countries (LMICs). High blood pressure (BP) and CVD risk have a strong, linear, and independent association. They contribute to alarming numbers of all-cause and CVD deaths. A major culprit for increased hypertension is sympathetic activity, and further complications of hypertension are heart failure, ischemic heart disease (IHD), stroke, and renal failure. Now, antihypertensive interventions have emerged as a global public health priority to reduce BP-related morbidity and mortality. Calcium channel blockers (CCB) are highly effective vasodilators. and the most common drugs used for managing hypertension and CVD. Cilnidipine, with both L- and N-type calcium channel blocking activity, is a promising 4th generation CCB. It causes vasodilation via L-type calcium channel blockade and inhibits the sympathetic nervous system (SNS) via N-type calcium channel blockade. Cilnidipine, which acts as a dual L/N-type CCB, is linked to a reduced occurrence of pedal edema compared to amlodipine, which solely blocks L-type calcium channels. The antihypertensive properties of cilnidipine are very substantial, with low BP variability and long-acting properties. It is beneficial for hypertensive patients to deal with morning hypertension and for patients with abnormal nocturnal BP due to exaggerated sympathetic nerve activation. Besides its BP-lowering effect, it also exhibits organ protection via sympathetic nerve inhibition and renin-angiotensin-aldosterone system inhibition; it controls heart rate and proteinuria. Reno-protective, neuroprotective, and cardioprotective effects of cilnidipine have been well-documented and demonstrated.
© Journal of the Association of Physicians of India 2024.
Address:
Senior Consultant Cardiologist, Department of Cardiology, Medanta-Moolchand Heart Centre; Chairman CME, Moolchand Medcity, Delhi, India; Country Head, American Heart Association; Chairman, World Wellness Foundation and World Heart Academy, Ludhiana, Punjab, India.; Professor and Head of Cardiology, Department of Cardiology, Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.; Consultant Cardiologist and Head of Department, Department of Cardiology in PD Hinduja Hospital & Medical Research Centre, Mumbai, Maharashtra, India.; Professor of Medicine and Cardiovascular Disease, Department of Medicine, UAB Heersink School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama, United States of America.; Chairman, Department of Nephrology and Renal Transplant Medicine, Max Super Speciality Hospital, Delhi, India.; Emeritus Professor, Department of Cardiology, Pushpagiri Institute of Medical Sciences, Thiruvalla, Kerala, India.; Director, Department of Invasive Cardiology, AMRI Hospitals, Kolkata, West Bengal, India.; Head, Department of Cardiology, PRS Hospital, Trivandrum, Kerala, India.; Emeritus Consultant Nephrologist, Department of Nephrology, Sir Ganga Ram Hospital, Delhi, India.; Chairman, Department of Nephrology and Kidney Transplant, Epitome Kidney Urology Institute & Lions Hospital, Delhi, India.; Chairman, Department of Cardiology, Sir Ganga Ram Hospital, Delhi, India.; Adjunct Professor Cardiology (NBE), Chairman, Department of Clinical and Preventive Cardiology, Medanta Heart Institute, Medanta - The Medicity, Gurugram, Haryana, India.; Senior Consultant Cardiologist, Department of Cardiology, Lisie Hospital, Kochi, Kerala, India.; Senior Vice Chairman and Head of Cardiology, Department of Cardiology, Medica Super Specialty Hospitals, Kolkata, West Bengal, India.; Chairman, Department of Interventional Cardiology, Medanta Heart Institute, Medanta - The Medicity, Delhi, India.; Professor and HOD, Department of Cardiology, Safdarjung Hospital, Delhi, India.; Principal Director and Chief of Cath Lab, Department of Cardiac Sciences, Max Super Speciality Hospital, Delhi, India.; HOD, Department of Medicine and Preventive Cardiology, Arihant Hospital, Indore, Madhya Pradesh, India.; Professor and Head, Department of Cardiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.; Director and Head, Department of Nephrology and Transplant Service, BLK-Max Super Speciality Hospital, Delhi; Max Hospital, Gurugram, Haryana, India.; Executive Director, Department of Cardiac Pacing and Electrophysiology, National Heart Institute of All India Heart Foundation, Delhi, India.; Director, Department of Cardiology, Fortis Escorts Heart Institute, National Heart Institute of All India Heart Foundation, Delhi, India.; Vice CEO and Head, Department of Cardiology Services, National Heart Institute of All India Heart Foundation, Delhi, India.; Cardiologist, Department of Cardiology, National Heart Institute, Delhi, India.; Ex-Director, Department of ICVS (Cardioogy), Institute of Post Graduate Medical Education & Research (IPGMER); Chief Cardiologist, Department of Cardiology, Dasbiswas Clinic, Kolkata, West Bengal, India.; Director, Department of Interventional Cardiology, Max Super Speciality Hospital, Delhi, India.; Member, Board of Directors, The International Board of Heart Rhythm Examiners (IBHRE); Director, Department of Cardiac Pacing and Electrophysiology, Fortis Escorts Heart Institute, Delhi, India.; Senior Director, Department of Cardiac Electrophysiology and Pacing, Medanta-The Medicity, Gurugram, Haryana, India.; Principal Director and Head, Department of Imaging, Fortis Escorts Heart Institute; Delhi, India.; Director and Head, Department of Noninvasive Cardiology and Heart Command Centre, Fortis Escorts Heart Institute; Delhi, India.; Advisor, Apollo Group of Hospitals; Senior Consultant and Coordinator, Department of Cardiology and Vascular Services, Indraprastha Apollo Hospital; Delhi, India.; Consultant Cardiologist, Department of Cardiology, Sir Ganga Ram Hospital; Delhi, India.; Senior Director, Department of Nephrology and Renal Transplant, Max Super Specialty Hospital; Delhi, India.; Professor Emeritus, Former HOD, Department of Pediatric Cardiology, Shri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.; Chairman, Department of Nephrology, Sir Ganga Ram Hospital, Delhi, India.; Senior Consultant Cardiologist, Department of Cardiology, Shrikrishna Institute of Management and Science, Chennai, Tamil Nadu, India.; Department of Cardiology, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India.; Cardiologist, Department of Cardiology, Med N Heart Clinic, Cuttack, Odisha, India.; Professor, Department of Cardiology, Srirama Chandra Bhanj Medical College & Hospital (SCB Medical College), Cuttack, Odisha, India.; Associate Director, In-charge, Department of Cardiology, Noninvasive Cardiac Laboratory, Max Smart Super Speciality Hospital, Delhi, India.; Senior Consultant Cardiologist, Department of Cardiology, Jay Prabha Medanta Super Speciality Hospital, Patna, Bihar, India.; Senior Director, Department of Clinical and Preventive Cardiology, Medanta-The Medicity, Gurugram, Haryana, India.; Executive Director and Chief Cardiologist, Department of Cardiology, Lifeline Superspeciality Hospital & Heart Centre, Jhansi, Uttar Pradesh, India.; Consultant and Head, Department of Nephrology and Transplant, Moolchand Hospital, Delhi, India.; Professor, Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.; HOD, Department of Medicine, Positron Multi-speciality Hospital; Formerly Senior Professor and HOD, Department of Medicine, Pt BD Sharma Postgraduate Medical Institute of Medical Science, Rohtak, Haryana, India.; Principal Director, Department of Nephrology and Kidney Transplant, Fortis Healthcare, Delhi, India.; Senior Consultant Physician, Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India.; Director and Consultant Diabetologist, Lifecare Diabetes Centre, Delhi, India.; Consultant Nephrologist, Department of Nephrology, Sri Balaji Action Medical Institute, Delhi, India.; Honorary Teaching Faculty, All India Institute of Medical Sciences; Consultant Physician, Kishori Ram Hospital, Bathinda, Punjab, India.; Director and Head, Department of Noninvasive Cardiology, Max Super Speciality Hospital, Delhi, India.; Cardiologist, Department of Cardiac Sciences, Fortis Healthcare, Delhi, India.; Senior Consultant, Department of Interventional Cardiology, Indraprastha Apollo Hospital, Delhi, India.; Senior Consultant, Department of Interventional Cardiology, Max Super Speciality Hospital, Delhi, India.; Senior Consultant Diabetologist, Director, North Delhi Diabetes Centre, Delhi, India.; Consultant, Department of Noninvasive Cardiology, Medanta Moolchand Heart Centre, Delhi, India.; Professor, Department of Internal Medicine, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, West Bengal, India.; Clinical Pharmacologist and Consultant Physician, Department of Pharmacology, Diabetes and Allergy-Asthma Therapeutics Specialty Clinic; Independent Clinical Pharmacologist, Kolkata, West Bengal, India, Corresponding Author.; Professor, Department of Medicine, R G Kar Medical College & Hospital, SDMC; Dean, Indian College of Physicians, Kolkata, West Bengal, India.; Consultant Physician and Diabetologist, Shilpa Medical Research Centre, Mumbai, Maharashtra; Editor-in-Chief, Journal of the Association of Physicians of India.
