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).
Subject(s)
Antihypertensive Agents/therapeutic use , Calcium Channel Blockers/therapeutic use , Exercise/physiology , Hemodynamics/drug effects , Hypertension/drug therapy , Nifedipine/analogs & derivatives , Adult , Amlodipine , Antihypertensive Agents/administration & dosage , Blood Pressure/drug effects , Blood Pressure Monitors , Calcium Channel Blockers/administration & dosage , Female , Heart Rate/drug effects , Humans , Hypertension/physiopathology , Male , Middle Aged , Nifedipine/administration & dosage , Nifedipine/therapeutic use , Time FactorsABSTRACT
Amlodipine administered once daily (5-10 mg) lowered blood pressure and reduced total peripheral resistance in patients with mild-to-severe essential hypertension without any reflex tachycardia. Heart pump function was maintained at rest and during exercise with a trend towards an increase in cardiac and stroke index. Amlodipine was effective and well tolerated in both young and elderly hypertensive patients with no reports of unpleasant vasodilator-related side effects.
Subject(s)
Calcium Channel Blockers/therapeutic use , Hemodynamics/drug effects , Hypertension/drug therapy , Nifedipine/analogs & derivatives , Physical Exertion/physiology , Adult , Amlodipine , Drug Administration Schedule , Female , Heart/drug effects , Heart Rate/drug effects , Humans , Male , Middle Aged , Nifedipine/therapeutic use , Stroke Volume/drug effects , Time Factors , Vascular Resistance/drug effectsABSTRACT
The long-term haemodynamic responses to amlodipine, a new long-acting calcium antagonist, were studied both at rest and during exercise in 18 patients (mean age 43 years) with essential hypertension. Blood pressure was measured intra-arterially, cardiac output by dye dilution and heart rate by electrocardiogram. After 11 months of treatment with 5-10 mg amlodipine once daily (mean dose 9 mg/day), mean arterial pressure was reduced by 14% sitting at rest. The reduction in blood pressure was associated with a marked reduction in the total peripheral resistance index (TPRI) of 19% (P less than 0.001). Similar responses were seen supine at rest and during 50W, 100W and 150W bicycle exercise. No significant changes were seen in heart rate. There was a slight increase in stroke index, and cardiac index was preserved at rest and during exercise with a slight trend towards an increase. In 10 of the patients, blood pressure was monitored by a portable blood pressure recorder (Accutracker II, Suntech Medical instruments, Raleigh, North Carolina, USA). Blood pressure was well controlled throughout the full 24 h period after one daily dose. In conclusion, amlodipine exerts a clear antihypertensive effect, both at rest and during exercise, through reduction in the TPRI and without a fall in cardiac pump function. No changes in heart rate were seen and there was no tendency for a reduction in the stroke index during 8 min of exercise at 150 W; on the contrary there was a trend towards an increase. The incidence of side-effects was low (ankle oedema in two patients).
Subject(s)
Calcium Channel Blockers/therapeutic use , Exercise/physiology , Hemodynamics/drug effects , Hypertension/drug therapy , Nifedipine/analogs & derivatives , Amlodipine , Blood Pressure/drug effects , Blood Pressure Monitors , Calcium Channel Blockers/administration & dosage , Female , Humans , Hypertension/physiopathology , Male , Middle Aged , Nifedipine/administration & dosage , Nifedipine/therapeutic use , Time FactorsABSTRACT
Liver and kidney samples obtained from 76 autopsies were analyzed for cadmium and zinc content. The patients had died of various internal diseases. None of them had any known occupational exposure to cadmium. A record was made of age, sex, place of residence, diagnosis, and smoking habits of each patient. The results showed no significant correlation between cadmium accumulation and hypertension or cardiovascular disease. There was, however, a significantly higher kidney cadmium level in smokers than in nonsmokers.