Manidipine did not affect sympathetic activity, measured as an increase in pulse pressure and heart rate, in a small study of 91 patients with type 2 diabetes, hypertension, and incipient nephropathy, compared to amlodipine. Both were add-on therapy in these patients who were already receiving a renin angiotensin blocker for a minimum of 6 months.°Dr. F. Javier Martinez-Martin°and colleagues from Las Palmas, Spain reported the study in a poster at the 15th Annual European Meeting of Hypertension, held June 17-21, 2005, in Milan.

Although both drugs lowered blood pressure to a similar degree, manidipine was better tolerated than amlodipine. Randomization was in a 2:1 fashion to either manidipine 20 mg daily or amlodipine 10 mg daily for 24 weeks.

Metanephrine and normetanephrine were positively correlated to pulse pressure and heart rate. Other findings are summarized in Table 1.

Table 1. Results in 91 patients receiving add-on therapy of manidipine and amlodipine

Manidipine Amlodipine P value
BP reduction (mm Hg) 19.1/7.7 12.7/10.9 <0.001 vs baseline
MAP reduction 11.5 11.5
Pulse pressure 11.3 1.8 <0.001
Heart rate (bpm) -1.2 +5.6 0.011
Albumin excretion (%) -65.5 -20.0 <0.001
Metanephrine/Cr quotients (%) -0.4 +15.2* *<0.001 vs baseline
Nometanephrine/Cr quotients (%) +0.5% +18.2%* *<0.001 vs baseline
Reported side effects (%) 8.2 27.7 0.26
Ankle edema (%) 3.3 26.7 0.002
Withdrawals (%) 1.6 16.7 0.014