Blood Pressure and Angina-Related Health Status During Benidipine Therapy: A Multicenter Real-World Cohort Study
Ayşegül Ülgen Kunak, Tolga Kunak, Ertan Aydın, Ümit Yaşar Sinan, Ali Nizami Elmas, Umut Uyan, Berkay Ekici, Onur Aslan, Baran Arık, Kübra Korkmaz, Mustafa Doğduş, Ahmet Ferhat Kaya, Nedret Ülvan, Serhat Çalışkan, Berkant 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 Duz, Harun Recep Narçiçeği, Yasin Deniz, Nezihe İlknur Bostanoğlu, Mehdi Zoghi, Asım Oktay ErgeneBackground: 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.