Long-Term Haemodynamic Effects of Amlodipine at Rest and during Exercise in Essential Hypertension

Lund‐Johansen, Per; Omvik, Per; White, William Β.; Digranes, Øivind; Helland, Bjørn; O, Jordal; Stray, Tore

doi:10.1159/000175046

Cited by 13 publications

(3 citation statements)

References 12 publications

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“…These differences might be explained by other effects of b1-adrenoceptor blockade, such as the decrease in cardiac contractility.In fact, atenolol has been shown to have negative inotropic effects when acutely administered [25,45,46]. However, studies employing atenolol in hypertensives for longer periods (1 to 5 years) did not observe this effect [47,48], suggesting that the effect is lost with time, as observed in heart failure [49]. As the drug was administered for 6 weeks in the present study, some of this negative inotropic effect might be still present.…”

Section: Figurementioning

confidence: 60%

Atenolol blunts blood pressure increase during dynamic resistance exercise in hypertensives

Gomides¹,

Costa²,

Souza³

et al. 2010

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Dynamic resistance exercise promotes a sizeable increase in blood pressure during its execution in non medicated hypertensives. WHAT THIS STUDY ADDS• Atenolol not only decreases blood pressure level but also mitigates the increase of blood pressure during dynamic resistance exercise in hypertensive patients. An increase in blood pressure during resistance exercise might be at least in part attributed to an increase in cardiac output. AIMSThis study was conducted to determine whether atenolol was able to decrease BP level and mitigate BP increase during dynamic resistance exercise performed at three different intensities in hypertensives. METHODSTen essential hypertensives (systolic/diastolic BP between 140/90 and 160/105 mmHg) were blindly studied after 6 weeks of placebo and atenolol. In each phase, volunteers executed, in a random order, three protocols of knee-extension exercises to fatigue: (i) one set at 100% of 1 RM; (ii) three sets at 80% of 1 RM; and (iii) three sets at 40% of 1 RM. Intra-arterial radial blood pressure was measured throughout the protocols. RESULTSAtenolol decreased systolic BP maximum values achieved during the three exercise protocols (100% = 186 Ϯ 4 vs. 215 Ϯ 7, 80% = 224 Ϯ 7 vs. 247 Ϯ 9 and 40% = 223 Ϯ 7 vs. 252 Ϯ 16 mmHg, P < 0.05). Atenolol also mitigated an increase in systolic BP in the first set of exercises (100% = +38 Ϯ 5 vs. +54 Ϯ 9; 80% = +68 Ϯ 11 vs. +84 Ϯ 13 and 40% = +69 Ϯ 7 vs. +84 Ϯ 14, mmHg, P < 0.05). Atenolol decreased diastolic BP values and mitigated its increase during exercise performed at 100% of 1 RM (126 Ϯ 6 vs. 145 Ϯ 6 and +41 Ϯ 6 vs. +52 Ϯ 6, mmHg, P < 0.05), but not at the other exercise intensities. CONCLUSIONSAtenolol was effective in both reducing systolic BP maximum values and mitigating BP increase during resistance exercise performed at different intensities in hypertensive subjects.

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Section: Figurementioning

confidence: 60%

Atenolol blunts blood pressure increase during dynamic resistance exercise in hypertensives

Gomides¹,

Costa²,

Souza³

et al. 2010

Brit J Clinical Pharma

View full text Add to dashboard Cite

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“…2 Comparison of changes in 24-h mean SBP/DBP according to treatment groups. SBP, systolic blood pressure; DBP, diastolic blood pressure; T40, Telmisartan40; SA2.5, S-Amlodipine2.5; T80, Telmisartan80 Result of chi-square test combination was more effective in correcting arteriolar vasodilatation and arterial stiffness [24][25][26]. This pathophysiology can be understood as the concept of BP variability.…”

Section: Discussionmentioning

confidence: 99%

Effect of a fixed-dose combination of Telmisartan/S-amlodipine on circadian blood pressure compared with Telmisartan monotherapy: TENUVA-BP study

et al. 2022

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Background This study evaluated the circadian efficacy of a telmisartan 40 mg/S-amlodipine 2.5 mg fixed-dose combination (Telmisartan40/S-Amlodipine2.5) compared to telmisartan 80 mg (Telmisartan80) in patients with essential hypertension who did not respond to 2–4 weeks’ treatment with telmisartan 40 mg. Methods Eligible patients with essential hypertension (clinic mean sitting systolic blood pressure [MSSBP] ≥140 mmHg, or ≥ 130 mmHg in those with diabetes mellitus or chronic kidney disease) were randomly assigned to Telmisartan40/S-Amlodipine2.5 or Telmisartan80 for 8 weeks. All patients underwent ambulatory BP monitoring (ABPM) at baseline and 8 weeks later. Primary endpoints were changes in mean 24-h SBP and DBP on 24-h ABPM from baseline after 8 weeks. Secondary endpoints were changes in daytime, nighttime, and morning SBP and DBP, and clinic MSSBP and MSDBP. Results A total of 316 Korean patients were enrolled, 217 patients were randomized to treatment, and 192 patients completed the study. Compared to Telmisartan80, Telmisartan40/S-Amlodipine2.5 showed significantly better reductions in 24-h mean SBP and DBP after 8 weeks. Telmisartan40/S-Amlodipine2.5 also significantly reduced secondary endpoints compared to Telmisartan80. Among 15 adverse events (7 [Telmisartan40/S-Amlodipine2.5] and 8 [Telmisartan80]), there were five adverse drug reactions; 14 events were mild, and none were identified with significant between-group differences. Conclusions Telmisartan40/S-Amlodipine2.5 was tolerable and more effective than Telmisartan80 in lowering 24-h mean ambulatory BP in patients with essential hypertension not responding adequately to Telmisartan40. Our findings support the fact that the combination of S-amlodipine with telmisartan is more appropriate than increasing the dose of telmisartan monotherapy. Trial registration ClinicalTrials.gov, NCT02231788. Registered 4 September 2014.

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“…Amlodipine at a mean dose of 10 mg effectively controlled BP throughout the 24 hours both at rest and during the exercise by lowering the total peripheral resistance without lowering the cardiac output. 29 Evidence of 24 Hours BP Control by Amlodipine…”

Section: Effect On Blood Pressure and Other Hemodynamic Effectsmentioning

confidence: 99%

24-Hour Blood Pressure Control with Amlodipine: A Review of the Current Scenario

Nair

Kumar

Unni

et al. 2022

Journal of Cardiac Critical Care TSS

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Introduction Hypertension is the leading cause of cardiovascular diseases and premature death worldwide. Antihypertensive therapy using calcium channel blockers (CCBs) is one of the preferred choices to treat blood pressure (BP) and control blood pressure variability (BPV). In contrast to clinic BP, 24-hour ambulatory BP monitoring (ABPM) has evolved into an accurate and reproducible tool for the assessment and management of hypertension. Amlodipine, a longer acting dihydropyridine CCB is effective for 24 hours BP control and also minimizing BPV. The present article is the comprehensive review highlighting the efficacy of amlodipine in controlling 24-hour BP and minimizing BPV from the review of recent studies. Materials and Methods The literature search was done using PubMed, Google Scholar, and MEDLINE databases. The studies to be included for review, were identified through the keywords: “amlodipine,” “ambulatory BP monitoring (ABPM),”“blood pressure variability (BPV),” “CCBs,” and filtering articles published in English language only. Results Pharmacological evidence suggests that amlodipine has the ability to block all the subtypes of CCBs such as L-, N-, P-, Q-, R-, and T-type. Various clinical studies reported that amlodipine is a powerful, well-tolerated, and safe antihypertensive agent which is widely used either alone or as a key component of combination therapy for control of 24 hours BP. Conclusion Overall, amlodipine is a proven and effective antihypertensive drug and helpful in controlling 24-hour BP, minimizing BP variability and hence reducing the risk of cardiovascular complications.

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Long-Term Haemodynamic Effects of Amlodipine at Rest and during Exercise in Essential Hypertension

Cited by 13 publications

References 12 publications

Atenolol blunts blood pressure increase during dynamic resistance exercise in hypertensives

Atenolol blunts blood pressure increase during dynamic resistance exercise in hypertensives

Effect of a fixed-dose combination of Telmisartan/S-amlodipine on circadian blood pressure compared with Telmisartan monotherapy: TENUVA-BP study

24-Hour Blood Pressure Control with Amlodipine: A Review of the Current Scenario

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