Does amlodipine cause slower heart rate
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These studies suggest amlodipine does not cause a slower heart rate and may increase heart rate in certain conditions.
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Does Amlodipine Cause a Slower Heart Rate?
Introduction to Amlodipine and Heart Rate
Amlodipine is a dihydropyridine calcium channel blocker commonly used to treat hypertension and angina pectoris. It works by inhibiting calcium influx into vascular smooth muscle and cardiac muscle cells, leading to vasodilation and reduced blood pressure. However, its effects on heart rate are a subject of interest and investigation.
Pharmacokinetics and Pharmacodynamics of Amlodipine
Amlodipine has a slow rate of elimination with an elimination half-life of 40-60 hours, which allows for once-daily dosing. It has high oral bioavailability and a gradual onset of action, which contributes to its steady pharmacodynamic profile. Importantly, studies have shown that amlodipine does not significantly change heart rate during both acute and chronic administration periods.
Comparative Studies on Heart Rate
In a study comparing the effects of amlodipine and nifedipine on heart rate and sympathetic nerve activity, it was found that amlodipine did not induce an increase in heart rate during chronic administration. This contrasts with short-acting nifedipine, which increased heart rate and sympathetic nerve activity. Another study confirmed that amlodipine does not significantly depress heart rate or produce negative inotropic effects, distinguishing it from other calcium channel blockers like diltiazem and verapamil.
Heart Rate Variability and Autonomic Balance
Research on heart rate variability (HRV) in hypertensive patients with stable angina pectoris showed that amlodipine did not significantly alter HRV time domain parameters. However, it did reduce the low-frequency to high-frequency ratio, indicating a shift towards increased vagal activity, which is generally associated with a more stable heart rate.
Circadian Rhythms and Heart Rate
A study on the effects of amlodipine on circadian rhythms in blood pressure and heart rate in rats found that while amlodipine dose-dependently decreased blood pressure, it caused a dose-dependent increase in heart rate, more pronounced during the light span. This suggests a circadian phase-dependency in the cardiovascular effects of amlodipine. However, in human studies, the overall impact on heart rate remains minimal and does not lead to significant clinical changes.
Clinical Implications and Conclusion
Overall, the evidence suggests that amlodipine does not cause a slower heart rate. Instead, it maintains heart rate stability without significant increases or decreases, making it a suitable option for patients who require blood pressure management without the risk of bradycardia or reflex tachycardia . This characteristic, along with its favorable pharmacokinetic profile, supports its use in treating hypertension and angina pectoris effectively and safely.
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