Blood pressure control with cilnidipine treatment in Japanese post-stroke hypertensive patients: The CA-ATTEND study

Figures & data

Figure 1. Breakdown of patients. Abbreviations: BP, blood pressure.

Table 1. Patient characteristics.

Items	Factors	Subjects analyzed (n = 2667)
Sex	Male	1610 (60.4%)
Age, years		69.0 ± 10.9
BMI, kg.m^−2		23.6 ± 3.6
mRS, Med (25th–75th percentiles)		1 (0–1)
	0	1230 (48.1%)
	1	751 (28.2%)
	2	304 (11.4%)
	3	164 (6.1%)
	≥4	165 (6.2%)
Concomitant disease present		1968 (73.8%)
Concomitant disease	Dyslipidemia	1230 (46.1%)
	Diabetes mellitus	441 (16.5%)
	Chronic kidney disease	132 (4.9%)
	Hepatic dysfunction	98 (3.7%)
	Coronary artery disease	135 (5.1%)
History of cerebrovascular disorder	Cerebral infarction	2150 (80.6%)
	Small vessel occlusion	1128 (42.3%)
	Large artery atherosclerosis	687 (25.8%)
	Cardioembolism	139 (5.2%)
	Others	218 (8.2%)
	Cerebral hemorrhage	340 (12.7%)
	Hypertensive cerebral hemorrhage	262 (9.8%)
	Other types of cerebral hemorrhage	78 (2.9%)
	Subarachnoid hemorrhage	223 (8.4%)
Smoking habit	Current smoker (<1 year of abstinence)
	or ex-smoker (≥1 year of abstinence)	1112 (41.7%)
	Never-smoker	1555 (58.3%)
Drinking habit	Present	982 (36.8%)
	Absent	1685 (63.2%)
Mean daily dose of cilnidipine, mg		10.2 ± 3.6
Concomitant antihypertensive medication present		1275 (47.8%)
Type of concomitant antihypertensive drugs	CCB	168 (6.3%)
	ARB	1095 (41.1%)
	ACE inhibitor	78 (2.9%)
	α-blocker	51 (1.9%)
	β-blocker	89 (3.3%)
	Diuretics	217 (8.1%)
Medication for dyslipidemia	Statin	746 (28.0%)
Concomitant antithrombotic medication present		1332 (49.9%)
Type of antithrombotic drugs	Clopidogrel	519 (19.5%)
	Aspirin	431 (16.2%)
	Cilostazol	346 (13.0%)
	Ticlopidine	39 (1.5%)
Anticoagulant	Warfarin	96 (3.6%)
Creatinine, mg/dL		0.86 ± 0.50
HbA1c, %		6.1 ± 1.0
Total cholesterol, mg/dL		193.0 ± 36.7
HDL cholesterol, mg/dL		55.8 ± 15.4
LDL cholesterol, mg/dL		112.9 ± 31.0
Triglycerides, mg/dL		141.8 ± 114.1

Abbreviations: ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; BMI, body mass index; CCB, calcium channel blocker; mRS, modified ranking scale; HDL, high-density lipoprotein; LDL, low-density lipoprotein.

Data are shown as the number of patients (%), the mean ± SD or median (25th–75th percentiles).

Figure 2. Time-course of changes in blood pressure and pulse rate. Abbreviations: BP, blood pressure; M, month or months; SBP, systolic blood pressure; DBP, diastolic blood pressure; PR, pulse rate. Data are presented as mean ± SD. *P < 0.05 vs. baseline (0M).

Figure 3. Changes in the proportion of patients categorized by clinic blood pressure and morning home blood pressure at baseline (0M), and after 4 months and 12 months. Abbreviations: SBP, systolic blood pressure; M, month or months; *P-values are for differences between two groups.

Figure 4. Difference in the time-course of clinic blood pressure by the clinical subtype of stroke. Abbreviations: BP, blood pressure; M, month or months; SBP, systolic blood pressure; DBP, diastolic blood pressure. Data are presented as mean ±SD. *P < 0.05 vs. baseline (0M).

Table 2. Blood pressure control status.

		Proportion achieving 140/90 mmHg				Proportion achieving 130/80 mmHg
		0M	12M	P value	No. of antihypertensive drug classes^1	0M	12M	P value	No. of antihypertensive drug classes^1
Overall patients	Total	21.5% (510/2370)	65.3% (1073/1642)	<0.001	0.68	9.1% (216/2370)	32.1% (527/1642)	<0.001	0.70
	Prior antihypertensive drug treatment present	24.8% (277/1119)	61.6% (480/779)	<0.001	1.31	11.1% (124/1119)	30.0% (234/779)	<0.001	1.34
Patients with small vessel occlusion	Total	19.5% (193/992)	63.5% (460/724)	<0.001	0.68	8.4% (83/992)	32.5% (235/724)	<0.001	0.73
	Prior antihypertensive drug treatment present	24.2% (111/458)	61.4% (208/339)	<0.001	1.30	10.7% (49/458)	31.9% (108/339)	<0.001	1.31
Patients with large artery atherosclerosis	Total	23.3% (137/587)	64.4% (261/405)	<0.001	0.57	9.7% (57/587)	25.2% (102/405)	<0.001	0.53
	Prior antihypertensive drug treatment present	24.2% (63/260)	59.3% (105/177)	<0.001	1.25	11.2% (29/260)	18.6% (33/177)	0.036	1.36
Patients with cerebral hemorrhage (hypertensive + other types of cerebral hemorrhage)	Total	23.7% (63/266)	64.1% (109/170)	<0.001	0.85	9.8% (26/266)	35.9% (61/170)	<0.001	0.84
	Prior antihypertensive drug treatment present	23.4% (34/145)	62.6% (57/91)	<0.001	1.42	9.7% (14/145)	33.0% (30/91)	<0.001	1.43
Patients with subarachnoid hemorrhage	Total	16.7% (29/174)	63.0% (68/108)	<0.001	0.60	9.2% (16/174)	34.3% (37/108)	<0.001	0.59
	Prior antihypertensive drug treatment present	17.5% (14/80)	56.6% (30/53)	<0.001	1.23	10.0% (8/80)	28.3% (15/53)	0.009	1.20
eGFR<60mL/min/1.73m^2	Total	22.7% (90/397)	64.6% (177/274)	<0.001	0.78	11.6% (46/397)	33.6% (92/274)	<0.001	0.84
	Prior antihypertensive drug treatment present	26.4% (57/216)	59.9% (88/147)	<0.001	1.32	14.4% (31/216)	30.6% (45/147)	<0.001	1.40
Patients with diabetes mellitus	Total	19.0% (74/390)	59.1% (150/254)	<0.001	0.87	8.2% (32/390)	30.3% (77/254)	<0.001	0.99
	Prior antihypertensive drug treatment present	22.3% (49/220)	57.6% (87/151)	<0.001	1.41	10.0% (22/220)	31.1% (47/151)	<0.001	1.47

¹This indicates how many classes of antihypertensive drugs from among 6 classes (CCB, ARB, ACE inhibitor, α-blocker, β-blocker, diuretic) were used before cilnidipine treatment in patients who reached the target BP

ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; BP, blood pressure; CCB, calcium channel blocker; eGFR, estimated glomerular filtration rate.

Hypertension. In Committee on the Japanese Guidelines for the Management of Stroke 2015, The Japan Stroke Society (eds), Japanese guidelines for the management of stroke 2015, KYOWA KIKAKU Ltd.: Tokyo, Japan, 2015, 24–26.

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