Influence of nifedipine coat-core and amlodipine on systemic arterial stiffness modulated by sympathetic and parasympathetic activity in hypertensive patients.
The aim of this study was to compare the effects of nifedipine coat-core (once daily formulation) and amlodipine on systemic arterial stiffness in patients with hypertension. Study drugs were assigned by the randomized open-label crossover method. After the blood pressure was maintained below 130/85 mm Hg for 8 months by treatment with either drug in 48 hypertensive patients (aged 63.2+/-6.9 years; 64.5% men), they were switched to the other drug for another 8 months. The blood pressure, heart rate, plasma catecholamine level and brachial-ankle pulse wave velocity were measured before and after a bicycle ergometer testing. Heart rate recovery was calculated from the change of the heart rate after treadmill exercise testing. The high-frequency and low-frequency components of the heart rate variability spectrum were analyzed from 24-h Holter electrocardiograms. The change of blood pressure after exercise testing showed no significant difference between the two medications. However, the increases of heart rate, noradrenalin and branchial-ankle pulse wave velocity after exercise were significantly smaller with nifedipine treatment than with amlodipine (P=0.0472, P=0.006 and P=0.0472, respectively). Heart rate recovery was significantly faster with nifedipine treatment (P=0.0280). The nighttime high-frequency component of heart rate variability was significantly larger after nifedipine treatment than after amlodipine (P=0.0259), while the nighttime low/high-frequency ratio was significantly smaller with nifedipine (P=0.0429). Nifedipine reduced functional arterial stiffness and improved heart rate recovery by altering the autonomic activity balance in hypertensive patients.
Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Kanagawa, Japan.
Michinari
M
Fukuda
Takashi
T
Masuda
Misao N
MN
Ogura
Tatsumi
T
Moriya
Keiji
K
Tanaka
Kazuya
K
Yamamoto
Akira
A
Ishii
Ryusuke
R
Yonezawa
Chiharu
C
Noda
Tohru
T
Izumi
D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage*; D001158:Arteries / Q000187:drug effects* / Q000294:innervation / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*
D002121:Calcium Channel Blockers; D017311:Amlodipine; D009543:Nifedipine