Measurement of long-term hemodynamic changes and the use of 24-hour blood pressure monitoring to evaluate treatment.
Hemodynamic studies at rest as well as during exercise are useful for profiling the hemodynamic derangements in essential hypertension and for evaluating the changes produced by antihypertensive therapy. Modern, lightweight, 24-hour ambulatory blood pressure monitoring devices can provide useful information in understanding circadian variation of blood pressure, and also in evaluating blood pressure control over 24 hours. We have studied in > 400 patients the hemodynamic profiles of most of the commonly used antihypertensive agents. Results from our study of amlodipine, a novel calcium antagonist, are presented as an example. Nineteen patients with mild-to-moderate essential hypertension underwent invasive hemodynamic studies while at rest, supine, and sitting, and during 50, 100, and 150 W bicycle exercise in the sitting position. Systolic, diastolic, and mean arterial blood pressure decreased 16% (p < 0.01) at rest and during exercise, and total peripheral resistance was reduced 18%. Blood pressure during the daytime and during sleep was reduced approximately 16%. The reductions in systolic and diastolic pressures were similar. There were no significant changes in heart rate or cardiac output. Amlodipine was well tolerated. Two patients developed ankle edema, which disappeared when the dose was reduced, and in 1 patient the drug was withdrawn because of nondrug-related side effects.
Lund-Johansen
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Medical Department, University of Bergen School of Medicine, Haukeland Hospital, Norway.
Omvik
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White
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W
D000328:Adult; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015924:Blood Pressure Monitors; D002302:Cardiac Output; D002940:Circadian Rhythm; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D014655:Vascular Resistance / Q000187:drug effects
D017311:Amlodipine