Amlodipine lowers blood pressure without increasing sympathetic activity or activating the renin-angiotensin system in patients with essential hypertension

• Published in: European journal of clinical pharmacology Vol. 53; no. 3-4; pp. 197 - 201
• Main Authors: SASAGURI, M, MATSUMOTO, N, NODA, K, KOGA, M, KINOSHITA, A, IDEISHI, M, ARAKAWA, K
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 1997; Berlin Springer Nature B.V
• Subjects: Aged; Amlodipine - pharmacology; Amlodipine - therapeutic use; Antihypertensive agents; Biological and medical sciences; Blood pressure; Blood Pressure - drug effects; Calcium Channel Blockers - pharmacology; Cardiovascular system; Female; Humans; Hypertension; Hypertension - drug therapy; Hypertension - physiopathology; Male; Medical research; Medical sciences; Middle Aged; Norepinephrine - blood; Pharmacology. Drug treatments; Renin - blood; Renin-Angiotensin System - drug effects; Sympathetic Nervous System - drug effects; Human; Hypertension; Calcium antagonist; Oral administration; Cardiovascular disease; Slow release form; Catecholamine; Sympathetic nervous system; Renin angiotensin system; Amlodipine; Neurotransmitter; Antihypertensive agent; Dihydropyridine derivatives; Norepinephrine; Mechanism of action
• DOI: 10.1007/s002280050362
• ISSN: 0031-6970

Recent clinical studies suggest that the reflex increase in sympathetic nervous activity accompanying a reduction in blood pressure may contribute to the untoward effects of dihydropyridine calcium antagonists. The aim of this study was to examine whether plasma noradrenaline levels and renin activity are increased with the reduction of blood pressure during the initial phase of administration of the long-acting dihydropyridine calcium antagonist amlodipine. The effects of amlodipine on ambulatory blood pressure and on diurnal variations in plasma noradrenaline and renin activity were examined 1, 4, and 7 days after the start of amlodipine administration in eight inpatients with essential hypertension. The 24-h mean systolic and diastolic blood pressure on day 7 was significantly lower than it was 1 day before the start of treatment. There was no change in the mean heart rate. The mean trough to peak ratios of systolic and diastolic blood pressure of seven patients were 61% and 71%, respectively. Diurnal patterns of plasma noradrenaline levels and renin activity 1, 4, and 7 days after the start of amlodipine administration were unchanged. The antihypertensive effects of amlodipine were of slow onset and long duration and were not accompanied by an increase in sympathetic activity or activation of the renin-angiotensin system.