Blood Pressure and Angina-Related Health Status During Benidipine Therapy: A Multicenter Real-World Cohort Study
Abstract
Background: Benidipine is a long-acting calcium channel blocker used for the treatment of hypertension and chronic coronary syndrome. Although it effectively lowers blood pressure (BP), the relationship between BP reduction and improvement in angina-related health status during benidipine therapy remains uncertain. This study evaluated changes in BP and patient-reported angina-related health status in a large real-world cohort. Methods: This prospective, multicenter, observational cohort study included 1659 patients with hypertension and/or chronic coronary syndrome who underwent baseline clinical assessment before initiation of benidipine therapy and were reassessed after 3 months. Changes in systolic and diastolic BP and Seattle Angina Questionnaire-7 (SAQ-7) scores were evaluated. Multivariable linear regression analyses were performed to identify predictors of BP reduction and symptomatic improvement. A propensity score-matched analysis according to coronary artery disease (CAD) status was conducted to further explore differences in treatment response. Results: The mean age was 62.2 ± 12.2 years, and 54.0% of participants were women. Systolic BP decreased by 13.8 mmHg and diastolic BP by 6.7 mmHg (both p < 0.001). Mean SAQ-7 score increased by 8.1 points (p < 0.001), exceeding the established threshold for clinically meaningful improvement. Baseline SAQ-7 score showed the strongest association with change in SAQ-7, whereas baseline systolic BP was the strongest predictor of BP reduction. The correlation between changes in systolic BP and SAQ-7 was weak (r = 0.058, p = 0.023). In the propensity score-matched cohort (n = 732), BP reduction was similar regardless of CAD status, whereas improvement in SAQ-7 was greater in patients without obstructive CAD. Conclusions: In this multicenter real-world cohort, benidipine therapy was associated with significant BP reduction and clinically meaningful improvement in angina-related health status over 3 months. Symptomatic improvement showed only a weak association with BP reduction. These findings should be interpreted within the limitations of an observational study and warrant confirmation in controlled comparative studies.
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Authors: Ayşegül Ülgen Kunak, Tolga Kunak, Ertan Aydın, Ümit Yaşar Si̇nan, Ali Nizami Elmas, Umut Uyan, Berkay Ekici, Onur Aslan, Baran Arık, K Korkmaz, Mustafa Doğduş, A. Kaya, Nedret Ülvan, Serhat Çalışkan, B. Öztürk, Zafer Kök, Murat Kerkütlüoğlu, Mehmet Kış, Sinan İnci, Mustafa Ahmet Huyut, Vedat Hekimsoy, Emrah Yeşil, Özkan Bekler, Sebahat Tekeli Şengül, Emrah Kaya, Aykut Demirkıran, Sefa Erdi Ömür, Halil İbrahim DURMUŞ, Şahbender Koç, Saadet Aydın, Fahrettin Katkat, Ömer Kümet, Murat Küçükukur, Aysu Oktay, Mehmet Ertürk, Taner Şen, Nurcemal Şentürk, Hatice Solmaz, Lütfü Bekar, Özkan Kayhan, Müge Ildızlı Demirbaş, Kenan Toprak, Sedat Kanat, Cenk Conkbayır, Alkame Akgümüş, Fahri Er, Ömer Bedir, Ramazan Düz, Harun Recep Narçiçeği, Yasin Deniz, Nezihe İlknur Bostanoğlu, Mehdi Zoghi, Asım Oktay Ergene
Institutions: Memorial Ankara Hospital, Ufuk University, Kutahya Saglik Bilimleri Universitesi, University of Health Sciences Antigua, Istanbul Medipol University, State Hospital, Education Training And Research, Giresun University, Mersin Üniversitesi, Kahramanmaraş Sütçü İmam University, Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu High Specialization Training and Research Hospital, University of Turku, Burdur Mehmet Akif Ersoy Üniversitesi, Ege University, Istanbul University, Sivas State Hospital, Ministry of Health, Antalya Eğitim ve Araştırma Hastanesi, Karadeniz Technical University, Usak University, Van Yüzüncü Yıl Üniversitesi, Bilkent University, Tekirdağ Namık Kemal University, Izmir University, Memorial Sisli Hospital, Sakarya Eğitim ve Araştırma Hastanesi, Istanbul Eye Hospital, Antalya IVF, Istanbul University-Cerrahpaşa, Tokat Gaziosmanpaşa Üniversitesi, Aksaray University, Samsun University, Başkent University Hospital, Dokuz Eylül University, Akdeniz University, Tarsus University, Eskişehir City Hospital, İzmir University of Economics, Kütahya Dumlupınar Üniversitesi, Ankara Numune Eğitim ve Araştırma Hastanesi, Hitit Üniversitesi, Harran University