Does amlodipine lower heart rate
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Does Amlodipine Lower Heart Rate?
Amlodipine, a calcium channel blocker, is widely used for treating hypertension and angina pectoris. However, its effects on heart rate are nuanced and vary depending on the context and dosage.
Amlodipine and Heart Rate Variability
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. A study comparing amlodipine and lacidipine found that while both drugs reduced total power and low-frequency power, amlodipine did not significantly change high-frequency power or the low-high frequency ratio, suggesting a shift towards increased vagal activity without a significant impact on heart rate.
Hemodynamic Effects of Amlodipine
In a study assessing the hemodynamic effects of intravenous amlodipine in patients with stable angina pectoris, it was observed that amlodipine actually increased heart rate slightly from 75 to 80 beats per minute. This increase was accompanied by a decrease in systemic vascular resistance and mean arterial pressure, indicating its vasodilatory effects without a significant negative impact on heart rate.
Circadian Rhythms and Heart Rate
A telemetric study in rats demonstrated that amlodipine's effects on heart rate are dose-dependent and influenced by the time of administration. The study found that amlodipine increased heart rate more significantly during the light phase compared to the dark phase, highlighting a circadian phase-dependency in its cardiovascular effects.
Clinical Trials and Observations
The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA) evaluated the efficacy of amlodipine-based therapy in older and younger patients. The study found that while amlodipine effectively reduced cardiovascular events, it did not significantly alter heart rate, reinforcing its safety profile in terms of heart rate management.
Pharmacological Properties
Amlodipine is known for its long-acting vasoselective properties, which contribute to its gradual onset of action and prolonged effect. Unlike other calcium channel blockers, amlodipine does not significantly depress heart rate or produce negative inotropic effects, making it a favorable option for patients requiring long-term management of hypertension and angina without the risk of bradycardia.
Conclusion
In summary, while amlodipine has various beneficial effects on blood pressure and myocardial ischemia, it does not significantly lower heart rate. In some cases, it may even cause a slight increase in heart rate due to its vasodilatory properties. This makes amlodipine a suitable option for patients who need effective blood pressure control without the risk of significant heart rate reduction.
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