The Experts below are selected from a list of 63519 Experts worldwide ranked by ideXlab platform

Yasuhiko Tomino - One of the best experts on this subject based on the ideXlab platform.

  • Renoprotective effects of the L-/T-type Calcium Channel Blocker benidipine in patients with hypertension.
    Current hypertension reviews, 2013
    Co-Authors: Yasuhiko Tomino
    Abstract:

    Abstract The renoprotective effects of benidipine, a Calcium Channel Blocker (CCB) developed in Japan, are reviewed herein. Benidipine has a sustained antihypertensive effect independent of its blood concentration since it binds to dihydropyridine (DHP) receptors via a "membrane approach" (approach to the cell membrane followed by long retention at the DHP binding site). Benidipine dilates glomerular afferent and efferent arterioles equally through inhibition of Ttype Ca Channels. Thus, it may cause a decrease of intraglomerular pressure and is superior to CCBs (capable of inhibiting only L-type Ca Channels) in terms of suppression of proteinuria. Additionally, benidipine suppresses worsening of renal function more powerfully than CCBs (suppressing only L-type Ca Channels), allowing better prognosis as to renal function. The inhibitory effect of benidipine on T-type Calcium Channels results in the suppression of aldosterone formation in the adrenal glands and of oxidative stress induced by aldosterone. Thus, the aldosterone-inhibitory and antioxidant activities of benidipine mediated by inhibition of T-type Calcium Channels would result in renoprotection and suppression of disease progression in hypertensive patients with chronic kidney disease (CKD). If such patients have proteinuria, renin-angiotensin system (RAS) inhibitors are used as first-line drugs, but benidipine, as an L-/T-type CCB, is recommended when they require some concomitant drugs. Moreover, the superiority of RAS inhibitors has not been demonstrated in hypertensive patients with CKD and without proteinuria. Thus, in such patients, benidipine should be considered as a first-line antihypertensive drug.

  • renoprotective effects of the l t type Calcium Channel Blocker benidipine in patients with hypertension
    Current Hypertension Reviews, 2013
    Co-Authors: Yasuhiko Tomino
    Abstract:

    Abstract The renoprotective effects of benidipine, a Calcium Channel Blocker (CCB) developed in Japan, are reviewed herein. Benidipine has a sustained antihypertensive effect independent of its blood concentration since it binds to dihydropyridine (DHP) receptors via a "membrane approach" (approach to the cell membrane followed by long retention at the DHP binding site). Benidipine dilates glomerular afferent and efferent arterioles equally through inhibition of Ttype Ca Channels. Thus, it may cause a decrease of intraglomerular pressure and is superior to CCBs (capable of inhibiting only L-type Ca Channels) in terms of suppression of proteinuria. Additionally, benidipine suppresses worsening of renal function more powerfully than CCBs (suppressing only L-type Ca Channels), allowing better prognosis as to renal function. The inhibitory effect of benidipine on T-type Calcium Channels results in the suppression of aldosterone formation in the adrenal glands and of oxidative stress induced by aldosterone. Thus, the aldosterone-inhibitory and antioxidant activities of benidipine mediated by inhibition of T-type Calcium Channels would result in renoprotection and suppression of disease progression in hypertensive patients with chronic kidney disease (CKD). If such patients have proteinuria, renin-angiotensin system (RAS) inhibitors are used as first-line drugs, but benidipine, as an L-/T-type CCB, is recommended when they require some concomitant drugs. Moreover, the superiority of RAS inhibitors has not been demonstrated in hypertensive patients with CKD and without proteinuria. Thus, in such patients, benidipine should be considered as a first-line antihypertensive drug.

Yoshiaki Kitazawa - One of the best experts on this subject based on the ideXlab platform.

  • Changes in optic nerve head blood flow and retrobular hemodynamics following Calcium-Channel Blocker treatment of normal-tension glaucoma
    International Ophthalmology, 1999
    Co-Authors: Goji Tomita, Yoshiaki Niwa, Hisashi Shinohara, Nobuhito Hayashi, Tetsuya Yamamoto, Yoshiaki Kitazawa
    Abstract:

    Background: Because Calcium Channel Blockers reduce vascularresistance, they may have a clinical application in the treatment ofnormal-tension glaucoma (NTG). This study investigates changes inboth the optic disc blood flow and the hemodynamics of retrobulbarvessels in NTG patients after the systemic administration of a Calcium Channel Blocker. Methods: Twelve eyes of 12 NTG patients (meanage 57 6 ± 15.3 years) were examined before and after a 4-weektreatment with 2 mg b.i.d. oral nilvadipine, an L-typc Calcium Channel Blocker. By scanning laser-Doppler flowmetry (SLDF), we obtained the velocity, flow, and volume from within a 10 × 10 pixel windowplaced on the temporal rim region of the optic disc perfusion map. Byultrasound color Doppler imaging (CDI), we measured the peak systolicvelocity (PSV) and the end diastolic velocity (EDV) of the ophthalmicartery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA). We then calculated a resistance index (RI) for each vessel. Results: After treatment, the flow and velocity of the optic disc blood flow significantly increased (P < 0.05).Nilvadipine also significantly reduced RIs of the CRA, NPCA, and TPCA(P

  • The effect of nilvadipine, a Calcium-Channel Blocker, on the hemodynamics of retrobulbar vessels in normal-tension glaucoma.
    Journal of glaucoma, 1998
    Co-Authors: Tetsuya Yamamoto, Yoshiaki Niwa, Hideaki Kawakami, Yoshiaki Kitazawa
    Abstract:

    Purpose To investigate the effect of nilvadipine, a Calcium-Channel Blocker, on the hemodynamics of retrobulbar vessels in normal-tension glaucoma. Methods Twenty-five patients who prospectively met the enrollment criteria underwent color Doppler imaging of the retrobulbar vessels before and alter receiving 4 weeks of treatment with 2 mg oral nilvadipine twice daily. Results Nilvadipine significantly increased the end-diastolic velocity in the central retinal artery and a short posterior ciliary artery. It significantly reduced the resistance index in the central retinal artery and posterior ciliary arteries, but not in the ophthalmic artery. The calculated ocular perfusion pressure was not affected. Results Conclusion:Oral nilvadipine reduces vascular resistance in distal retrobulbar arteries in normal-tension glaucoma without affecting more proximal blood vessels. Therefore, nilvadipine may have a beneficial effect on the hemodynamics of retrobulbar vessels in normal-tension glaucoma.

W H L Kao - One of the best experts on this subject based on the ideXlab platform.

Kohji Shirai - One of the best experts on this subject based on the ideXlab platform.

  • protective effects of efonidipine a t and l type Calcium Channel Blocker on renal function and arterial stiffness in type 2 diabetic patients with hypertension and nephropathy
    Journal of Atherosclerosis and Thrombosis, 2009
    Co-Authors: Hidehisa Sasaki, Atsuhito Saiki, Kei Endo, Hidetoshi Kawana, D Nagayama, Tomokazu Oyama, Yoh Miyashita, Masahiro Ohhira, Takashi Yamaguchi, Kohji Shirai
    Abstract:

    Aim: The three types of Calcium Channel Blocker (CCB), L-, T- and N-type, possess heterogeneous actions on endothelial function and renal microvascular function. In the present study, we evaluated the effects of two CCBs, efonidipine and amlodipine, on renal function and arterial stiffness.Methods: Forty type 2 diabetic patients with hypertension and nephropathy receiving angiotensin receptor II Blockers were enrolled and randomly divided into two groups: the efonidipine group was administered efonidipine hydrochloride ethanolate 40 mg/day and the amlodipine group was admin-istered amlodipine besilate 5 mg/day for 12 months. Arterial stiffness was evaluated by the cardio-ankle vascular index (CAVI).Results: Changes in blood pressure during the study were almost the same in the two groups. Sig-nificant increases in serum creatinine and urinary albumin and a significant decrease in the esti-mated glomerular filtration rate were observed in the amlodipine group, but not in the efonidipine group. On the other hand, significant decreases in plasma aldosterone, urinary 8-hydroxy-2'-deoxy-guanosine and CAVI were observed after 12 months in the efonidipine group, but not in the amlo-dipine group.Conclusions: These results suggest that efonidipine, which is both a T-type and L-type Calcium chan-nel Blocker, has more favorable effects on renal function, oxidative stress and arterial stiffness than amlodipine, an L-type Calcium Channel Blocker.

A Y Chu - One of the best experts on this subject based on the ideXlab platform.