One of the major problems in treatment patients of hypertension (HTN) is controlling their systolic blood pressure (SBP) and diastolic BP (DBP). Amlodipine, a calcium channel blocker is frequently used in the treatment of hypertension. Since Amlodipine primarily L-type calcium channel blocker (CCB) and thus reduces blood pressure, it stimulates sympathetic nerve activity leading to reflex increase in heart rate. Cilnidipine, a new type of CCB which can inhibit L- type calcium channels but also N-type calcium channels.  

Objective is to determine whether cilnidipine is more effective and safer than amlodipine in controlling the blood pressure of hypertensive patients. The study was a non-randomized comparative clinical trial study, conducted in the in the outdoor chamber of Chattogram General Hospital & CSCR (Pvt.) Limited, Chittagong over a period of 4 years from June 2019 to May 2023. Total of 418 hypertensive patients were enrolled in the study. Among them 209 patients were randomized to the amlodipine group and 209 to the cilnidipine group. The blood pressure, pulse rate and adverse effects were monitored in each patient over 6 months of intervention. The difference in the Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and pulse rate before and after treatment within each group, and between the two groups were analyzed using paired and unpaired t tests respectively. The adverse effects reported in each group were analyzed using Chi-square test. In this study, after 6 months of intervention, systolic blood pressure was statistically significant between two groups (unpaired t-test and t= -4.47, p=0.001) and also significant was found within the groups when compared baseline vs after 6 months of intervention, mean changes of systolic blood pressure were significantly higher in Amlodipine group than Cilnidipine group (32.9±17.2 vs -25.4±15.8 mmHg). The mean diastolic blood pressure were not statistically significant between two groups (Unpaired t-test and p>0.05) and but significant difference was found within the groups when compared baseline vs after 6 months of intervention. After 3 months and 6 months of intervention, the mean changes of diastolic blood pressure were almost similar between two groups. Majorities of the patients in both Amlodipine (69.9%) and Cilnidipine (62.2%) groups achieved control over blood pressure (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg) with no significant difference between the study groups (2 = 2.73, p = 0.098). The incidence of pedal oedema was significantly higher in the Amlodipine group than that in the Cilnidipine group (2 = 5.56, p = 0.018) but complications were not significant between two groups.Both Cilnidipine and Amlodipine are equally effective in reducing blood pressure in hypertensive individuals. However, Amlodipine more often causes albuminuria than Cilnidipine does leading to pedal oedema.

To be updated