Erratum to: Amlodipine. A reappraisal of its pharmacological properties and therapeutic use in cardiovascular disease

Haria, Malini; Wagstaff, Antona J.

doi:10.1007/bf03259149

Cited by 80 publications

(112 citation statements)

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“…19,20 It may not be, in contrast, a prominent effect of amlodipine, which has a limited lipophilicity and has been shown to be accompanied by a persistent sympathostimulation when given to hypertensive patients with or without renal failure. 19,[37][38][39] Three other points deserve to be mentioned. One, in our hypertensive patients different measures of sympathetic activity such as HR, plasma NE, and MSNA changed in a remarkably similar fashion in response to the acute and chronic administration of felodipine or lercanidipine.…”

Section: Discussionmentioning

confidence: 99%

Short-Versus Long-Term Effects of Different Dihydropyridines on Sympathetic and Baroreflex Function in Hypertension

et al. 2003

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Abstract-Antihypertensive treatment with dihydropyridines may be accompanied by sympathetic activation. Data on whether this is common to all compounds and similar in the various phases of treatment are not univocal, however. In 28 untreated essential hypertensives (age, 56.4Ϯ1.8 years; meanϮSEM) finger blood pressure (BP, Finapres), heart rate (HR, ECG), plasma norepinephrine (NE, high-performance liquid chromatography), and muscle sympathetic nerve traffic (MSNA, microneurography) were measured at rest and during baroreceptor manipulation (vasoactive drugs) in the placebo run-in period and after randomization to double-blind acute and chronic (8 weeks) felodipine (10 mg/d, nϭ14) or lercanidipine (10 mg/d, nϭ14). Acute administration of both drugs induced pronounced BP reductions and marked increases in HR, NE, and MSNA. After 8 weeks of treatment, BP reductions were similar to those observed after acute administration, whereas HR, NE, and MSNA responses were markedly attenuated (Ϫ7%, Ϫ32%, and Ϫ14%, respectively; PϽ0.05). There was a small residual increase in sympathetic activity in the felodipine group, whereas in the lercanidipine group, all adrenergic markers returned to baseline values. Baroreflex control of HR and MSNA was markedly impaired (Ϫ42% and Ϫ48%, respectively) after acute drug administration, with a recovery and complete resetting during chronic treatment. Thus, the sympathoexcitation induced by 2 different dihydropyridines is largely limited to the acute administration. The 2 drugs have, nevertheless, a different chronic sympathetic effect, indicating that dihydropyridines do not homogeneously affect this function. The acute sympathoexcitation, but not the small between-drugs differential chronic adrenergic effect, is accounted for by baroreflex impairment. Key Words: autonomic nervous system Ⅲ sympathetic nervous system Ⅲ baroreflex Ⅲ calcium Ⅲ hypertension, essential S everal studies have shown that the hyperadrenergic state characterizing essential hypertension (1) favors the development and progression of the hypertensive state, 1-7 (2) promotes and accelerates the occurrence of the hypertensionrelated cardiac and vascular damage, 5-9 and (3) adversely modulates metabolic cardiovascular risk factors, including insulin resistance. [3][4][5]7,10 This implies that antihypertensive treatment should be based on drugs that are capable of not only effectively reducing the elevated blood pressure (BP) but also avoiding the neuroadrenergic activation that may be reflexly triggered by the BP-lowering response. 6 -8,10 -12 The effect of calcium antagonists of the dihydropyridine class on sympathetic cardiovascular drive has been investigated in a number of studies that have produced, however, different results (ie, an increase, no change, or even a decrease in sympathetic activity). [13][14][15][16][17][18][19][20] This could be due to the different pharmacokinetic and/or pharmacodynamic properties of the drugs examined. 21 It could also be accounted for, however, by the different characteristics o...

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Section: Discussionmentioning

confidence: 99%

Short-Versus Long-Term Effects of Different Dihydropyridines on Sympathetic and Baroreflex Function in Hypertension

et al. 2003

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“…13,14 Whereas amlodipine is an intrinsically long-acting agent with an elimination half-life of 35-50 h, nifedipine has a short half-life (approximately 2 h) but is formulated in a GITS that provides constant release of the drug over a 24-h period.…”

Section: Discussionmentioning

confidence: 99%

Persistence of the antihypertensive efficacy of amlodipine and nifedipine GITS after two ‘missed doses’: a randomised, double-blind comparative trial in Asian patients

Ongtengco

Moralès²,

Sanderson

et al. 2002

J Hum Hypertens

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Suboptimal management of hypertension is often a result of poor patient compliance in the form of missed doses of their antihypertensive medication. This multicentre, randomised, double-blind, parallel-group trial was designed to compare the persistence of the antihypertensive efficacy of the amlodipine and nifedipine gastrointestinal therapeutic system (GITS) after two 'missed doses', and also to compare the drugs' overall efficacy and safety in Asian patients with mild-tomoderate essential hypertension. Following a 2-week placebo run-in period, 222 patients were randomised to receive either amlodipine (5 mg daily, increased after 6 weeks if necessary to 10 mg daily, n ¼ 109) or nifedipine GITS (30 mg daily, increased after 6 weeks if necessary to 60 mg daily; n ¼ 113) for 12 weeks. A placebo was then substituted for further 2 days with continuous ambulatory blood pressure (BP) monitoring. The increases in the last 9 h of mean ambulatory BP on day 2 after treatment withdrawal were significantly less with amlodipine than with nifedipine GITS: 4.4 7 7.0 vs 11.2 7 11.3 mmHg for systolic BP (Pp0.0001) and 2.4 7 6.3 vs 6.0 7 6.0 mmHg for diastolic BP (Pp0.0002). Significant differences between the two drugs in mean 24-h ambulatory BP levels were already evident on day 1 after withdrawal, even though there were no significant differences on the final day of treatment. No differences in safety parameters were observed, and neither drug caused any serious or severe treatment-related adverse events. In conclusion, amlodipine provides greater protection than nifedipine GITS against loss of BP control following missed doses.

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“…They also have significant blood pressure lowering effects and prevent cardiovascular events. 20 Indications for the use of CCBs include hypertension together with angina pectoris, left ventricular hypertrophy and carotid/coronary atherosclerosis ( Table 1). The CCB in most single-pill, fixed-dose ARB/CCB combinations is amlodipine, which has a long half-life of 30 -50 h. 21 …”

Section: Role Of the Ccb In Arb/ Ccb Combination Therapymentioning

confidence: 99%

Efficacy and Safety of Angiotensin II Type 1 Receptor Blocker/Calcium Channel Blocker Combination Therapy for Hypertension: Focus on a Single-Pill Fixed-Dose Combination of Valsartan and Amlodipine

Miura

Saku

2012

J Int Med Res

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Erratum to: Amlodipine. A reappraisal of its pharmacological properties and therapeutic use in cardiovascular disease

Cited by 80 publications

References 0 publications

Short-Versus Long-Term Effects of Different Dihydropyridines on Sympathetic and Baroreflex Function in Hypertension

Short-Versus Long-Term Effects of Different Dihydropyridines on Sympathetic and Baroreflex Function in Hypertension

Persistence of the antihypertensive efficacy of amlodipine and nifedipine GITS after two ‘missed doses’: a randomised, double-blind comparative trial in Asian patients

Efficacy and Safety of Angiotensin II Type 1 Receptor Blocker/Calcium Channel Blocker Combination Therapy for Hypertension: Focus on a Single-Pill Fixed-Dose Combination of Valsartan and Amlodipine

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