2018 Volume 25 Issue 6 Pages 490-504
Aims: Although several antihypertensive agents reduced the carotid intima–media thickness (IMT), it remains unclear whether those agents affect the interadventitial diameter (IAD). We aimed to examine whether cilnidipine, an L/N-type calcium channel blocker, reduced the common carotid IMT or IAD in post-stroke hypertensive patients.
Methods: The common carotid IMT and IAD were measured at the start of cilnidipine treatment and 12 months from that. The changes in the mean max-IMT or IAD between baseline and the 12-month follow-up were evaluated and compared between the thick group (max-IMT ≥1.1 mm) and the normal group (max-IMT <1.1 mm).
Results: A total of 603 post-stroke hypertensive subjects (mean age=69.3 yr, 378 males) were included in the analysis. At baseline, IAD was increased stepwise according to the value of max-IMT (p for trend <0.001). Among them, 326 subjects were followed up for 12 months. The mean max-IMT from baseline to 12 months did not change in the normal group (-0.01 mm, 95% confidence interval [CI] -0.03 to 0.01, n=170), whereas a significant reduction was observed in the thick group (-0.09 mm, 95% CI -0.13 to -0.05, n=156). The mean IAD was significantly reduced during the study period in the normal group (-0.14 mm, 95% CI -0.22 to -0.05) as well as in the thick group (-0.12 mm, 95% CI -0.21 to -0.03).
Conclusions: Cilnidipine promoted the regression of common carotid IMT in post-stroke hypertensive patients, especially in the thick group. Cilnidipine also reduced the IAD in both normal and thick groups.