Does nifedipine lower heart rate
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The Impact of Nifedipine on Heart Rate
Introduction to Nifedipine and Heart Rate
Nifedipine is a calcium channel blocker commonly used to treat hypertension and angina. It works primarily by dilating blood vessels, which reduces blood pressure. However, its effects on heart rate are complex and can vary depending on the dosage and formulation.
Nifedipine and Heart Rate Increase
Hemodynamic Effects in Congestive Heart Failure
Studies have shown that nifedipine can lead to an increase in heart rate. For instance, in patients with mild to moderate congestive heart failure, a single sublingual dose of 20 mg of nifedipine resulted in a significant increase in heart rate from 73.3 to 80.9 beats per minute. This increase is likely a reflex response to the vasodilation and subsequent drop in blood pressure caused by nifedipine.
Pharmacokinetic Studies in Hypertensive Patients
In hypertensive patients, different doses of nifedipine (20, 40, and 60 mg) also led to significant increases in heart rate, ranging from 29% to 38% above baseline levels. The peak increase occurred around two hours after administration and lasted for about five hours. This suggests that the heart rate increase is dose-dependent and correlates with the plasma concentration of nifedipine.
Comparison with Other Antihypertensive Agents
When compared with other antihypertensive agents like nitrendipine and clonidine, nifedipine was found to increase heart rate significantly. In a study involving patients with hypertensive emergencies, nifedipine increased heart rate from 89 to 103 beats per minute within one hour of administration. This contrasts with nitrendipine and clonidine, which either decreased or had no significant effect on heart rate.
Nifedipine Formulations and Heart Rate
Controlled-Release vs. Retard Formulations
The formulation of nifedipine can influence its effect on heart rate. For example, nifedipine controlled-release (CR) did not significantly change the 24-hour heart rate, whereas nifedipine retard increased it by approximately 3.9 beats per minute. This indicates that the controlled-release formulation may have a more stable effect on heart rate compared to the retard formulation.
Gastrointestinal Therapeutic System (GITS) Formulation
In another study comparing nifedipine GITS with verapamil, nifedipine GITS was associated with an increase in early morning heart rate by 2.6 beats per minute, whereas verapamil decreased it. This further supports the notion that nifedipine, depending on its formulation, can lead to an increase in heart rate.
Conclusion
In summary, nifedipine generally leads to an increase in heart rate, which is a reflex response to its vasodilatory effects and subsequent drop in blood pressure. This increase is dose-dependent and can vary with different formulations of the drug. While nifedipine is effective in lowering blood pressure, its impact on heart rate should be carefully considered, especially in patients with cardiovascular conditions.
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