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Long-term haemodynamic effects of amlodipine at rest and during exercise in essential hypertension
P Lund-Johansen1, P Omvik, W White
1Medical Department, University of Bergen School of Medicine, Haukeland Sykenhus, Norway.
Insights
Long-term amlodipine treatment effectively lowers blood pressure in essential hypertension patients. This medication significantly reduces arterial pressure and total peripheral resistance with minimal side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a common condition requiring effective long-term management.
- Calcium channel blockers, like amlodipine, are frequently used to treat hypertension.
Purpose of the Study:
- To evaluate the long-term effects of amlodipine on haemodynamic responses in patients with essential hypertension.
- To assess blood pressure control and side effects during extended amlodipine therapy.
Main Methods:
- 18 patients with essential hypertension received amlodipine (5-10 mg daily) for a mean of 11 months after a placebo run-in.
- Intra-arterial blood pressure, cardiac output (dye dilution), and heart rate (ECG) were measured.
- Ambulatory blood pressure monitoring was performed in 10 patients.
Main Results:
- Amlodipine significantly reduced systolic and diastolic arterial pressure by 16% and 14% at rest, respectively.
- Total peripheral resistance index decreased by 19% (p < 0.001).
- Effective 24-hour blood pressure control was observed with a low incidence of side effects.
Conclusions:
- Long-term amlodipine treatment is effective in managing essential hypertension.
- Amlodipine reduces blood pressure by decreasing peripheral resistance.
- The drug is well-tolerated with a low side effect profile.
Abstract:
Haemodynamic responses at rest and during exercise were studied in 18 patients with essential hypertension following long-term treatment with amlodipine. Patients underwent a 2-week placebo run-in period followed by a mean duration of 11 months' treatment with amlodipine 5-10 mg (mean dose 9 mg) once daily. Blood pressure was measured intra-arterially, cardiac output by dye dilution and heart rate by electrocardiogram. Amlodipine produced a mean reduction in systolic and diastolic arterial pressure of 27 and 16 mm Hg, respectively, at rest and after exercise. At rest sitting, mean systolic and diastolic arterial pressures were reduced by 16 and 14% (p less than 0.01), respectively, from initial mean values of 182.4/111.2 mm Hg. This reduction in blood pressure was associated with a marked reduction in the total peripheral resistance index of 19% (p less than 0.001). Similar responses were observed at rest supine and during exercise. No significant changes were seen in heart rate. Stroke index showed a small increase at rest and during exercise together with a trend towards an increase in cardiac index after treatment with amlodipine. Ambulatory blood pressure monitoring was carried out in 10 patients after the placebo run-in and at the end of the study. Amlodipine showed effective blood pressure control throughout the 24 h after one daily dose. The incidence of side effects was low (ankle oedema in 2 patients).