Evaluation of changes in sympathetic nerve activity and heart rate in essential hypertensive patients induced by amlodipine and nifedipine
Evaluation of changes in sympathetic nerve activity and heart rate in essential hypertensive patients induced by amlodipine and nifedipine
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DOI：
10.1097/00004872-199816010-00016
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发表时间：
1998-01-01
影响因子：
4.9
通讯作者：
Shigemasa, C
中科院分区：
文献类型：
--
作者：
Hamada, T;Watanabe, M;Shigemasa, C
目的比较硝苯地平（Nifedipine，NPH）和苯地平（Nifedipine，NPH）在急性和慢性治疗期间对心率和交感神经活动参数的影响，以阐明其对心血管结局的影响。在对照（预处理）期间，在第一天（急性期）和4周（慢性期）后，测定血浆和尿中的儿茶酚胺水平，服用硝苯地平和短效硝苯地平或其缓释制剂。心率功率谱分析得到低频和高频功率谱密度以及低频：高频比值。结果在慢性期，硝苯地平、短效硝苯地平和缓释硝苯地平均能显著降低血压。在硝苯地平缓释给药的慢性期内，每24小时的QRS总计数保持不变，并因硝苯地平给药而增加，但因硝苯地平给药而减少2.8%。在慢性期，给药硝苯地平可降低血浆和尿去甲肾上腺素水平，而短效硝苯地平可显著增加血浆和尿去甲肾上腺素水平，而缓释硝苯地平则不会改变血浆和尿去甲肾上腺素水平。虽然低频：短效硝苯地平可使高血压病患者交感神经高频活动率明显增加，缓释硝苯地平可使高血压病患者交感神经高频活动率增加，而缓释硝苯地平可使高血压病患者交感神经高频活动率增加，这表明在其长期给药后可以预期对原发性高血压的有益作用。与短效硝苯地平相比，缓释硝苯地平的给药诱导的交感神经反射激活较轻。(C)1998 Rapid Science Ltd.
Objective To compare the effects of amlodipine and nifedipine on heart rate and parameters of sympathetic nerve activity during the acute and chronic treatment periods in order to elucidate their influence on cardiovascular outcome.Design A randomized and single-blind study.Methods We performed 24 h ambulatory electrocardiography and blood pressure monitoring of 45 essential hypertensive inpatients. Plasma and urinary catecholamine levels were measured during the control (pretreatment) period, on the first day (acute period) and after 4 weeks (chronic period) of administration of amlodipine and of short-acting nifedipine or its slow-releasing formulation. The low-frequency and high-frequency power spectral densities and low-frequency : high-frequency ratio were obtained by heart rate power spectral analysis.Results Blood pressure was significantly and similarly reduced by administrations of amlodipine, short-acting nifedipine and slow-releasing nifedipine during the chronic period. The total QRS count per 24 h, which remained constant during the chronic period of administration of slow-releasing nifedipine and was increased by administration of nifedipine, was decreased by 2.8% by administration of amlodipine. Administration of amlodipine decreased the plasma and urinary norepinephrine levels during the chronic period, whereas the levels were significantly increased by administration of short-acting nifedipine and not changed by administration of slow-release nifedipine. Although low-frequency : high-frequency ratio was increased significantly by administration of short-acting nifedipine and slightly by administration of slow-releasing nifedipine, administration of amlodipine reduced it during the acute and chronic periods.Conclusions Administration of amlodipine did not induce an increase in sympathetic nerve activity in essential hypertensive patients during the chronic period, suggesting that beneficial effects on essential hypertension can be expected after its long-term administration. Administration of slow-releasing nifedipine induces milder reflex sympathetic activation than does that of short-acting nifedipine. (C) 1998 Rapid Science Ltd.