Haemodynamic Assessment in Safety Pharmacology

Evaluation of the effects of a drug on arterial blood pressure is important in nonclinical safety pharmacology assessment. Detecting large and obvious changes in blood pressure is an unchallenging task. Detecting small changes is more difficult, and interpretation of findings requires careful risk/benefit evaluation. Detecting subtle and small changes in blood pressure is important in particular with respect to increases, since blood pressure above the normal range is associated with increased risk of stroke and sudden cardiac death. Cardiovascular safety pharmacology has been preoccupied with drug-induced changes in the electrocardiogram, and by comparison, there has been little in the way of contemporaneous improvements in the level of complexity and sophistication involved in blood pressure assessment. Thus, it is important to understand the nature of drug-induced changes in blood pressure, appreciate the plethora of agents currently used clinically (and over the counter) that alter blood pressure and understand safety pharmacology study design in order to optimize assessment of a new chemical entity (NCE) or biologic agent in this context.