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Amlodipine as an antiischemic drug is superior to long acting nitrates
Goran P Koraćević1, Sonja S Dakić2, Radmila M Veličković-Radovanović3
1Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z. Djindjića 48, 18000 Niš, Serbia, Medical Faculty, University of Niš, Bulevar Dr Zorana Djindjića 81, 18 000 Niš, Serbia.
Insights
Calcium channel blockers, like amlodipine, reduce angina episodes more effectively than long-acting nitrates. Amlodipine offers additional benefits for hypertension patients, potentially reducing polypharmacy.
Area of Science:
- Cardiology
- Pharmacology
Background:
- European Society of Cardiology Guidelines recommend treatments for angina.
- Long-acting nitrates are a common treatment for stable angina pectoris.
- Arterial hypertension often coexists with stable angina.
Purpose of the Study:
- To compare the efficacy of amlodipine versus long-acting nitrates in stable angina patients.
- To highlight advantages of amlodipine in patients with coexisting hypertension.
- To explore amlodipine's potential in reducing polypharmacy.
Main Methods:
- Meta-analysis results cited by European Society of Cardiology Guidelines.
- Comparative analysis of amlodipine and long-acting nitrates.
- Review of amlodipine's effects on hypertension and target organ damage.
Main Results:
- Calcium channel blockers, including amlodipine, result in fewer angina episodes per week compared to long-acting nitrates.
- Amlodipine offers advantages such as treating hypertension, reducing left ventricular hypertrophy, and preventing morning blood pressure surges.
- Amlodipine's once-daily dosing improves adherence and it does not cause tolerance or rebound effects.
Conclusions:
- Amlodipine is a preferred option over long-acting nitrates for stable angina patients, particularly those with arterial hypertension.
- Amlodipine can decrease polypharmacy without compromising efficacy.
- The multifaceted benefits of amlodipine support its use in managing complex cardiovascular conditions.
Abstract:
European Society of Cardiology Guidelines cite results of meta-analysis that the use of calcium channel blockers results in fewer angina episodes per week vs. long-acting nitrates. Moreover, we listed 12 reasons more to prefer amlodipine over long-acting nitrates, especially in stable angina pectoris patients with arterial hypertension. It may be the way to decrease polypharmacy without loosing efficacy. Some important advantages of amlodipine versus long-acting nitrate(s) are: amlodipine also treats hypertension, it helps reducing hypertensive target organ damages (e.g. left ventricular hypertrophy) and prevents morning blood pressure surge. Moreover, amlodipine can be given once daily (which improves adherence), it produces neither tolerance nor rebound, it has less side effects.
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