Does amlodipine lower pulse rate
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The Impact of Amlodipine on Pulse Rate: A Comprehensive Review
Introduction to Amlodipine and Pulse Rate
Amlodipine, a calcium channel blocker, is widely used to manage hypertension and angina. While its efficacy in lowering blood pressure is well-documented, its effects on pulse rate (PR) are less clear. This article synthesizes findings from multiple studies to determine whether amlodipine lowers pulse rate.
Amlodipine and Pulse Rate: Mixed Results
No Significant Reduction in Pulse Rate
Several studies indicate that amlodipine does not significantly reduce pulse rate. For instance, a study comparing azelnidipine and amlodipine found that while azelnidipine significantly decreased PR, amlodipine did not cause a notable reduction in this parameter. Another study involving a double-blind comparison of amlodipine and hydrochlorothiazide reported no clinically significant changes in pulse rate with amlodipine treatment.
Increase in Pulse Rate
Contrary to the expectation of a reduction, some studies have observed an increase in pulse rate with amlodipine. A study monitoring the effects of azelnidipine and amlodipine on 24-hour blood pressure and pulse rate found that while azelnidipine decreased PR by 2 beats per minute, amlodipine increased it by 4 beats per minute. Additionally, a telemetric study in rats showed a dose-dependent increase in heart rate with amlodipine, particularly during the light span.
Combination Therapies and Pulse Rate
When combined with other antihypertensive agents, amlodipine's effect on pulse rate can vary. For example, a study evaluating the combination of bisoprolol and amlodipine found that while bisoprolol alone significantly reduced heart rate, the addition of amlodipine did not further alter this reduction. Similarly, another study noted that combining amlodipine with valsartan or atenolol resulted in different impacts on heart rate, with the amlodipine-atenolol combination leading to a more significant decrease in heart rate compared to the amlodipine-valsartan combination.
Conclusion
The evidence suggests that amlodipine does not consistently lower pulse rate and may even increase it in some cases. Its effect on pulse rate appears to be influenced by the presence of other medications and the specific conditions of the study. Therefore, while amlodipine is effective in managing blood pressure, its impact on pulse rate should be carefully considered, especially in patients where heart rate control is crucial.
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