Cilnidipine in management of patients with uncontrolled hypertension and white-coat effect

Introduction: Hypertension is a major public health problem worldwide. It is an established risk factor in the prognosis of cardiovascular diseases and organ damage [1]. Cilnidipine is a long-acting antihypertensive agent that lowers blood pressure by inhibiting L-type calcium channels directly associated with vascular tone, and N-type calcium channels related to sympathetic nervous activity [2]. Because it acts specifically on N-type calcium channels, cilnidipine is expected to achieve better reduction in morning blood pressure than other classes of calcium channel blockers, and to attenuate the white-coat effect caused by sympathetic nerve hyperactivity. Incomplete drug-regimen compliance (DRC) and white-coat hypertension are two of several possible causes of uncontrolled hypertension. Therefore, in this study, cilnidipine was evaluated in reducing morning blood pressure at home and in ameliorating the white-coat effect.