Amlodipine lower heart rate
Pro Research Analysisby 
Searched over 200M research papers
The Impact of Amlodipine on Heart Rate: A Comprehensive Review
Introduction to Amlodipine and Heart Rate
Amlodipine, a calcium channel blocker, is widely used to treat hypertension and angina pectoris. Its effects on heart rate (HR) are of particular interest, especially in patients with cardiovascular conditions. This article synthesizes findings from multiple studies to understand how amlodipine influences heart rate.
Amlodipine and Heart Rate Variability
Influence on Heart Rate Variability (HRV)
Research indicates that amlodipine affects heart rate variability (HRV), a measure of autonomic nervous system activity. A study comparing amlodipine and lacidipine found that while both drugs reduced total power and low-frequency power, amlodipine uniquely decreased the low-high frequency ratio, suggesting a shift towards increased vagal activity . This shift indicates a reduction in sympathetic nervous system activity, which can be beneficial for cardiovascular health.
Hemodynamic Effects of Amlodipine
Acute and Chronic Effects on Heart Rate
Amlodipine's hemodynamic effects include a modest increase in heart rate. In a study involving intravenous administration of amlodipine, heart rate increased from 75 to 80 beats per minute within 15 minutes . This increase is attributed to the drug's vasodilatory effects, which reduce systemic vascular resistance and trigger a reflex increase in heart rate.
Comparison with Other Calcium Channel Blockers
When compared to nifedipine, another calcium channel blocker, amlodipine showed a different profile in terms of sympathetic nerve activity. Amlodipine decreased plasma and urinary norepinephrine levels, indicating reduced sympathetic activation, whereas short-acting nifedipine increased these levels . This suggests that amlodipine may have a more favorable impact on heart rate and sympathetic activity over the long term.
Circadian Rhythms and Dosing Time
Morning vs. Evening Dosing
The timing of amlodipine administration can influence its effects on heart rate and blood pressure. A study comparing morning and evening dosing found that morning administration resulted in a greater nocturnal fall in blood pressure and a more stable heart rate profile . This suggests that morning dosing may be more effective in managing circadian variations in cardiovascular parameters.
Comparative Efficacy in Angina Pectoris
Amlodipine vs. Ivabradine
In patients with stable angina, amlodipine was compared to ivabradine, a heart-rate-lowering agent. While ivabradine significantly reduced heart rate at rest and during exercise, amlodipine did not have a significant impact on heart rate but was effective in improving exercise tolerance and reducing anginal attacks . This highlights amlodipine's efficacy in angina management without significantly lowering heart rate.
Conclusion
Amlodipine has a complex but generally favorable impact on heart rate. It tends to increase heart rate slightly due to its vasodilatory effects but also shifts autonomic balance towards increased vagal activity, reducing sympathetic nervous system influence. The timing of administration and comparison with other agents like nifedipine and ivabradine further elucidate its nuanced effects. Overall, amlodipine remains a valuable option in cardiovascular therapy, particularly for its benefits in hypertension and angina pectoris.
Sources and full results
Most relevant research papers on this topic