Amlodipine lowers heart rate
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
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 manage hypertension and angina pectoris. Its effects on heart rate (HR) have been a subject of interest, given its role in cardiovascular therapy. This article synthesizes findings from multiple studies to understand how amlodipine influences heart rate.
Amlodipine and Heart Rate Variability
Heart Rate Variability in Hypertensive Patients
Research indicates that amlodipine does not significantly alter heart rate variability (HRV) parameters in hypertensive patients with stable angina pectoris and isolated left ventricular diastolic dysfunction. However, it does reduce the influence of the sympathetic autonomic nervous system, shifting the autonomic balance towards increased vagal activity.
Comparative Studies with Other Antihypertensive Agents
In a study comparing amlodipine with other antihypertensive agents, it was found that amlodipine significantly reduced blood pressure variability (BPV) and heart rate variability (HRV) over a three-month period. This reduction in HRV was associated with a decrease in blood pressure, suggesting an improvement in autonomic nervous system regulation.
Hemodynamic Effects of Amlodipine
Acute and Chronic Effects on Heart Rate
Amlodipine has been shown to increase heart rate slightly when administered intravenously. In a study involving patients with stable angina pectoris, heart rate increased from 75 to 80 beats per minute after administration, indicating a mild positive chronotropic effect. Additionally, long-term administration of amlodipine in hypertensive patients did not induce an increase in sympathetic nerve activity, which is beneficial for cardiovascular outcomes.
Circadian Rhythms and Heart Rate
Amlodipine's effects on circadian rhythms in heart rate were studied in rats, revealing a dose-dependent increase in heart rate that was more pronounced during the light span compared to the dark span. This suggests a circadian phase-dependency in the cardiovascular effects of amlodipine.
Clinical Implications and Safety
Reduction in Myocardial Ischemia
Amlodipine has been effective in reducing both symptomatic and asymptomatic myocardial ischemia in patients with chronic stable angina. This reduction was observed over a 24-hour period, maintaining the intrinsic circadian pattern of ischemia.
Comparison with Other Antianginal Agents
In a comparative study with ivabradine, amlodipine showed similar efficacy in improving exercise tolerance and reducing anginal attacks. However, ivabradine had a superior effect on reducing the rate-pressure product, a surrogate marker of myocardial oxygen consumption.
Safety Profile
Amlodipine is generally well-tolerated, with common vasodilator adverse events such as edema, headaches, and flushing. It does not cause postural hypotension, reflex tachycardia, or cardiac conduction disturbances, making it a safe option for long-term use in hypertensive and angina patients.
Conclusion
Amlodipine has a complex but generally favorable impact on heart rate and heart rate variability. While it may cause a slight increase in heart rate acutely, it does not significantly alter heart rate variability in the long term and can improve autonomic balance by reducing sympathetic activity. Its efficacy in reducing myocardial ischemia and maintaining a stable heart rate makes it a valuable therapeutic option in cardiovascular disease management.
Sources and full results
Most relevant research papers on this topic