Can amlodipine lower heart rate
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Can Amlodipine Lower Heart Rate?
Amlodipine, a calcium channel blocker, is widely used for the treatment of hypertension and angina pectoris. However, its effects on heart rate are complex and can vary depending on the context and patient population.
Amlodipine and Heart Rate Variability
Studies have shown that amlodipine can influence heart rate variability (HRV), which is a measure of the variation in time between each heartbeat. In a study involving hypertensive patients with stable angina pectoris, amlodipine did not significantly change HRV time domain parameters, but it did reduce the low-high frequency ratio, indicating a shift towards increased vagal activity and reduced sympathetic activity. This suggests that while amlodipine may not directly lower heart rate, it can modulate autonomic control in a way that could potentially influence heart rate indirectly.
Hemodynamic Effects of Amlodipine
In another study assessing the hemodynamic effects of intravenous amlodipine in patients with stable angina, it was found that amlodipine actually increased heart rate slightly from 75 to 80 beats per minute. This increase in heart rate was accompanied by a decrease in systemic vascular resistance and mean arterial pressure, indicating a vasodilatory effect. The increase in heart rate could be a reflex response to the vasodilation and subsequent drop in blood pressure.
Circadian Rhythms and Heart Rate
Research on the circadian effects of amlodipine in rats showed a dose-dependent increase in heart rate, which was more pronounced during the light phase of the day. This phase-dependent response suggests that the timing of amlodipine administration could influence its effects on heart rate.
Comparative Studies with Other Medications
Comparative studies have also provided insights into the effects of amlodipine on heart rate. For instance, a study comparing amlodipine with ivabradine, a heart-rate-lowering agent, found that while ivabradine significantly reduced heart rate, amlodipine did not have a similar effect. This indicates that amlodipine's primary mechanism of action does not involve direct heart rate reduction.
Conclusion
In summary, while amlodipine can influence heart rate variability and autonomic balance, it does not typically lower heart rate directly. In some cases, it may even cause a slight increase in heart rate due to its vasodilatory effects. Therefore, amlodipine is not primarily used for heart rate reduction, and its effects on heart rate can vary depending on the specific clinical context and patient population.
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