Amlodipine as an antiischemic drug is superior to
long acting nitrates

• Authors: Goran P. Koraćević , Sonja S. Dakić , Radmila M. Veličković-Radovanović , Svetlana R. Apostolović , Nebojša H. Krstić , Ivan S. Tasić , Marija D. Zdravković , Nebojša M. Antonijević , Goran N. Damnjanović , Tomislav L. Kostić
• Languages of publication: EN

Abstracts

EN

European Society of Cardiology Guidelines cite
results of meta-analysis that the use of calcium channel
blockers results in fewer angina episodes per week vs.
long-acting nitrates. Moreover, we listed 12 reasons more
to prefer amlodipine over long-acting nitrates, especially
in stable angina pectoris patients with arterial hypertension.
It may be the way to decrease polypharmacy without
loosing efficacy. Some important advantages of amlodipine
versus long-acting nitrate(s) are: amlodipine also
treats hypertension, it helps reducing hypertensive target organ damages (e.g. left ventricular hypertrophy) and prevents
morning blood pressure surge. Moreover, amlodipine
can be given once daily (which improves adherence),
it produces neither tolerance nor rebound, it has less side
effects.

Keywords

EN

Amlodipine; Long acting nitrates; Stableangina pectoris

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 10
• Issue: 1

Dates

published

1 - 1 - 2015

accepted

1 - 4 - 2014

received

2 - 10 - 2013

online

3 - 11 - 2014

Contributors

author

Goran P. Koraćević

• Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z.Djindjića 48, 18000 Niš, Serbia

author

Sonja S. Dakić

• Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z.Djindjića 48, 18000 Niš, Serbia

author

Radmila M. Veličković-Radovanović

• Medical Faculty, University of
  Niš, Bulevar Dr Zorana Djindjića 81, 18 000 Niš, Serbia
• Department of Clinical Pharmacology, Clinical center Niš, Bulevar Dr
  Zorana Djindjića 48, 18 000 Serbia

author

Svetlana R. Apostolović

• Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z.Djindjića 48, 18000 Niš, Serbia

author

Nebojša H. Krstić

• Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z.Djindjića 48, 18000 Niš, Serbia

author

Ivan S. Tasić

• Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z.Djindjića 48, 18000 Niš, Serbia
• Institute for therapy and prevention Niška Banja, Srpskih junaka 2,
  18 205 Niška Banja, Serbia

author

Marija D. Zdravković

• Clinical Hospital Center Bežanijska kosa,
  Faculty of Medicine, Univesirty of Belgrade, Bežanijska kosa bb, 11
  000 Belgrade, Serbia

author

Nebojša M. Antonijević

• School of Medicine, Belgrade, Clinic of
  Cardiology, Clinical Centre of Serbia, Pasterova 2, 11 000 Belgrade,
  Serbia

author

Goran N. Damnjanović

• Military Hospital Niš, Bulevar Dr Zorana
  Đinđića bb, 18 000 Niš, Serbia

author

Tomislav L. Kostić

• Department for Cardiovascular Diseases, Clinical center Niš, Bulevar Dr Z.Djindjića 48, 18000 Niš, Serbia

References

• [1] Gayet J.L., Paganelli F., Cohen-Solal A., Update on the medicaltreatment of stable angina, Arch Cardiovasc Dis., 2011, 104(10),536-544[Crossref]
• [2] Morrow D., Gersh B., Chronic coronary artery disease, In:Libby P., Bonow R., Mann D., Zipes D. (Eds), Braunwald’s heartdisease: A textbook of Cardiovascular Medicine, 8th ed.,Saunders Elsevier, Philadelphia, 2007
• [3] Fihn S.D., Gardin J.M., Abrams J., Berra K., Blankenship J.C.,Dallas A.P., et al., 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STSGuideline for the Diagnosis and Management of Patients WithStable Ischemic Heart Disease, J Am Coll Cardiol., 2012, 60(24),2564-2603[Crossref]
• [4] Parker J.D., Parker J.O., Stable angina pectoris: the medicalmanagement of symptomatic myocardial ischemia, Can JCardiol.,2012, 28(2 Suppl), S70-80
• [5] Jackson N.C., Lee P.S., Reynolds G., Frais M., Taylor S.H.,Improvement of treadmill time to angina by amlodipine, Br JClin Pharmac., 1985, 20, 248
• [6] Hall R., Chong C., A double-blind, parallel-group study ofamlodipine versus long-acting nitrate in the management ofelderly patients with stable angina, Cardiology, 2001, 96(2),72-77[Crossref]
• [7] Lanza G.A., Colonna G., Pasceri V., Maseri A., Atenolol versusamlodipine versus isosorbide-5-mononitrate on anginalsymptoms in syndrome X, Am J Cardiol., 1999, 84(7), 854-856,A8[Crossref]
• [8] Rinaldi C.A., Linka A.Z., Masani N.D., Avery P.G., Jones E.,Saunders H., et al., Randomized, double-blind crossoverstudy to investigate the effects of amlodipine and isosorbidemononitrate on the time course and severity of exerciseinducedmyocardial stunning, Circulation, 1998, 25, 98(8),749-756[Crossref]
• [9] Steffensen R., Melchior T., Bech J., Nissen H., Haastrup B.,Grande P., et al., Effects of amlodipine and isosorbide dinitrateon exercise-induced and ambulatory ischemia in patients withchronic stable angina pectoris, Cardiovasc Drugs Ther., 1997,11(5), 629-635[Crossref]
• [10] Mancia G., de Backer G., Dominiczak A., Cifkova R., FagardR., Germano G., Guidelines for the menagement for arterialhypertension|: executive summary: The Task Force onMenagement of Arterial Hypertension of European Society ofHypertension (ESH) and of the European Society of Cardiology(ESC), Eur Heart J., 2007, 28, 1462-1536
• [11] Kloner R.A, Sowers J.R., DiBona G.F., Gaffney M., Wein M., Sexandage- related antihypertensive effects of amlodipine. Theamlodipine Cardiovascular Community Trial Study Group, Am JCardiol., 1996, 77, 713-722[Crossref]
• [12] Wang J.G., Kario K., Lan T., Wei Y.Q., Park C.G., Kim C.H., etal., Asian Pacific Heart Association. Use of dihidropyridinecalcium channel blockers in the management of hypertensionin Eastern Asians: a scientific statement from the Asian PacificHeart Association, Hypertens Res., 2011, 34(4), 423-430[Crossref]
• [13] Levy D., Anderson K.M., Savage D.D., Kannel W.B., ChristiansenJ.C., Castelli W.P., Echocardiographically detected leftventricular hypertrophy: prevalence and risk factors. TheFramingham Heart Study, Ann Intern Med., 1988, 108(1), 7-13[Crossref]
• [14] Terpstra W.F., May J.F., Smit A.J., de Graeff P.A., Havinga T.K.,van den Veur E., et al., Long-term effects of amlodipine andlsinopril on left ventricular mass and diastolic function inelderly,previosly untreated hypertensive patients: the ELVERAtrial, J Hypertens., 2001, 19(2), 303-309[Crossref]
• [15] Islim I.F., Watson R.D., Ihenacho H.N., Ebanks M., SinghS.P., Amlodipine: effective for treatment of mild to moderateesential hypertension and left ventricular hypertrophy,Cardiology, 2001, 96 Suppl 1, 10-18
• [16] Bakris G.L., Sarafidis P.A., Weir M.R., Dahlöf B., Pitt B.,Jamerson K., Renal outcomes with different fixed-dosecombination therapies in patients with hypertension at highrisk for cardiovascular events (ACCOMLISH): a prespecifiedsecondary analysis of a randomised controlled trial, Lancet,2010, 375(9721), 1173-1181
• [17] Lacourcière Y., Crikelair N., Glazer R.D., Yen J., Calhoun D.A.,24-Hour ambulatory blood pressure control with triple-therapyamlodipine, valsartan and hydrochlorothiazide in patients withmoderate to severe hypertension, J Hum Hypertens., 2011, 25,615-622[Crossref]
• [18] Parati G., Schumacher H., Bilo G., Manicia G., Evaluating24-h antihypertensive efficacy by the smoothness index. Ameta-analysis of an ambulatory blood pressure monitoringdatabase, J Hypertens., 2010, 28, 2177-2183
• [19] Mulcahy D., Purcell H., Fox K., Should we get up in themorning? Observations on circadian variations in cardiacevents, Br Heart J., 1991, 65(6), 299-301[Crossref]
• [20] Eguchi K., Kario K., Shimada K., Effects of long-acting ACEinhibitor (temocapril) and long-acting Ca channel blocker(amlodipine) on 24-h ambulatory BP in elderly hypertensivepatients, J Hum Hypertens., 2001, 15, 64
• [21] Deanfield J.E., Detry J.M., Selliner P., Lichtlen P.R., ThaulowE., Bultas J., et al., Medical treatment of myocrdial ischemiain coronary artery disease: effect of drug regime and irregulardosing in the CAPE II trial, J Am Coll Cardiol., 2002, 40, 917-925[Crossref]
• [22] Ninomiya Y., Hamasaki S., Saihara K., Ishida S., Kataoka T.,Ogawa M., et al., Comparison of effect between nitrates andcalcium channel antagonist on vascular function in patientswith normal or mildly diseased coronary arteries, HeartVessels, 2008, 23(2), 83-90[Crossref]
• [23] Preston Mason R., Pleiotropic effects of calcium channelblockers, Curr Hypertens Rep., 2012, 14(4), 293-303[Crossref]
• [24] Nissen S.E., Tuzcu E.M., Libby P., Thompson P.D., Ghali M.,Garza D., et al., Effect of antihypertensive agents on cardiovascularevents in patients with coronary disease and normalblood pressure: the CAMELOT study: a randomised controlledtrial, JAMA, 2004, 292(18), 2217-2225
• [25] Jukema J.W., van der Hoorn J.W., Amlodipine and atorvastatinin atherosclerosis: a review of the potential of combinationtherapy, Expert Opin Pharmacother., 2004, 5(2), 459-468
• [26] Toba H., Nakagawa Y., Miki S., Shimizu T., Yoshimura A., InoueR., et al., Calcium channel blockades exhibit anti-inflamatoryand antioxidative effects by augmentation of endothelial nitric oxide sinthase and the inhibition of angitensin convertingenzyme in the N(G)-nitro-L-arginine methyl ester-inducedhypertensive rat aorta: vasoprotective effects beyond theblood pressure-lowering effects of amlodipine and manidipine,Hypertens Res., 2005, 28(8), 689-700
• [27] Ohba T., Watanabe H., Murakami M., Radovanovic M., IlnoK., Ishida M., et al., Amlodipine inhibits cell proliferation viaPKD1-related pathway, Biochem Biophys Res Commun., 2008,369(2), 376-381
• [28] Batova S., De Wever J., Godfraind T., Balligand J.L., Dessy C.,Feron O.,The Calcium channel blocker amlodipine promotesthe unclamping of eNOS from caveolin in endothelial cells,Cardiovasc Res., 2006, 71(3), 478-485[Crossref]
• [29] Hernández R.S., Armas-Hernández M.J., Chourio J.A., Armas-Padilla M.C., López L., Alvares M., et al., Comparativeeffects of amlodipine and nifedipine GITS during treatment andafter missing two doses, Blood Press Monit., 2001, 6(1), 47-57[Crossref]
• [30] Marchand X., Tibi T., Bernaud C., Morand P., Evaluationof amlodipine in stable effort angina. Comparation withdiltiazem in terms of efficacy, tolerability and maintence of theantiischemic action 24 hours after the last dose, Ann CardiolAngeiol., 1996, 45(2), 74-82
• [31] Taylor A.A., Ragbir S., Three in one: safetty, efficacy, andpatient acceptability of triple fixed-dose combination medicinein the menagement of hypertension, Patient PreferedAdherence, 2012, 6, 555-563
• [32] Hatala R., Pella D., Hatalova K., Sidlo R., Optmisation of bllodpressure treatment with fixed-combination perindopril/amlodipine in patients with arterial hypertension, Clin DrugInvest., 2012, 32(9), 603-612
• [33] Punzi H., Shojaee A., Maa J.F.; on behalf of the BP-CRUSHInvestigators., Efficacy and tolerability of fixed-doseamlodipine/olmesartan medoxomil with or without hydrochlorothiazidein Hispanic and non-Hispanic patients whose bloodpressure is uncontrolled on antihypertensive monotherapy,Ther Advr Cardiovasc Dis., 2012, 6(4), 149-161
• [34] McGibney D., The efficacy of amlodipine in the managementof ischaemic heart disease, Postgrad Med J., 1991, 67 Suppl 3,S24-28
• [35] Palma-Gámiz J.L., High blood pressure and calciumantagonism, Cardiology, 1997,88 Suppl 1,39-46
• [36] Ishmitsu T., Minami J.,Yashii M., Suzuki T., Inada H., Ohta S., etal., Comparation of the effects of amlodipine and losartan on24-hour ambulatory blood pressure in hypertensive patients,Clin Exp Hypertens., 2002, 24(1-2), 41-50[Crossref]
• [37] Ajayi A.A., Akintomide A.O., The efficacy and tolerability ofamlodipine and hydrochloothiazide in Nigerians with essentialhypertension, J Natl Med Assoc., 1995, 87(7), 485-488
• [38] Sasaguri M., Matsumoto N., Noda K., Koga M., Kinoshita A.,Ideishi M., et al., Amlodipine lowers blood pressure withoutincreasing sympathetic activity or activating the reninangiotensinsystem in patients with essential hypertension,Eur J Clin Pharmacol., 1997, 53(3-4), 197-201[Crossref]
• [39] Mroczek W.J., Burris J.F., Klein J., A double–blind evaluationof the effect of amlodipine on ambulatory blood pressure,Postgrad Med J., 1991, 67 Suppl 5, S24
• [40] Abernethy D.R., Pharmacokinetics and pharmacodinamics ofamlodipine, Cardiology, 1992, 80 Suppl 1, 31-36
• [41] Naidu M.U., Usha P.R., Rao T.R., Shobha J.C., et al., Evaluationof amlodipine, lisinopril and a combination in the treatmentof essential hypertension, Postgrad Med J., 2000, 76(896),350-353[Crossref]
• [42] Hagar J.M., Newman L.G.,Kloner R.A., Effects of amlodipineon myocardial infarction, infarct expansion and ventriculargeometry in the rat, Am Heart J., 1992, 124(3), 571-580[Crossref]
• [43] Milovanovic B., Trifunovic D., Milicevic N., Vasic K., Krotin M.,The significance of amlodipine on autonomic nervous systemadjustment (ANSA method): a new approach in the treatment ofhypertension, Srp Arh Celok Lek., 2009, 137(7-8), 371-378
• [44] Mancia G., Omboni S., Zanchetti A., Clinical adventeges oflipophilic dihydropiridines, Blood Press Suppl., 1998, 2, 23-26
• [45] Siché J.P., Baquet J.P.,Faqret P., Trémel F., de GaudemarisR., Mallion J.M., Effects of amlodipine on baroreflex andsympathetic nervous system activity in mild-to-moderatehypertension, Am J Hypertens., 2001,14(5Pt1), 424-428[Crossref]
• [46] Lund-Johansen P., Omvik P., White W., Digrones O., Helland B.,Jordal O., et al., Long-term haemodinamic effects of amlodipineat rest and during exercise in essential hypertension, PostgradMed J., 1991, 67 Suppl 5, S20-23
• [47] Huraib S., Askar A, Abu-Aisha H., Al-Wakeel J., Mitwalli A.,Al-Majed S., et al., Efficacy of once-daily amlodipine in thecontrol of 24-hour blood pressure using ambulatory bloodpressure monitoring, Curr Therap Res., 1995, 56(11), 1125–1131[Crossref]
• [48] Khong S.M., Andrews K.L., Huynh N..N, Venardos K., ApricoA., Michell D..L, et al., Arginase II inhibition prevents nitratetolerance, Br J Pharmacol., 2012, 166(7), 2015-2023
• [49] Fox K., Garcia M.A., Ardissino D., Buszman P., Camici P.G.,Crea F., et al., Guidelines on the menagement of stableangina pectoris: executive summary: The Task Force on theMenagement of Stable Angina Pectoris of the European Societyof Cardiology, Eur Heart J., 2006, 27(11), 1341-1381
• [50] Meredith P.A., Therapeutic implications of drug “holidays”, EurHeart J., 1996, 17 Suppl A, 21-24
• [51] Ongtengco I., Morales D., Sanderson J., Lu Z.R., Beilin L.J.,Burke V., et al., Persistence of the antihypertensive efficacy ofamlodipine and nifedipine GITS after two “missed doses”: arandomised, double-blind comparative trial in Asian patients, JHum Hypertens., 2002, 16(11), 805-813[Crossref]
• [52] Mehta J.L., Lopez L.M., A double-blind evaluation of amlodipinein patients with chronic, stable angina: sustanied efficacyand lack of “withdrawal phenomenon” upon abrupt discontinuation,Clin Cardiol., 1994, 17(9 Suppl 3), III17-22
• [53] Gorwit J., Haidet G.C., Russell D.C., Tonkon M., Deedwania P.C.,Borer J.S., Randomised Placebo-Controlled Withdrawal Study ofamlodipine in Angina Pectoris, Am J Ther., 1995, 2(1), 34-42[Crossref]
• [54] Koracevic G., Significance of “beta blocker reboundphenomenon” and new suggestions how to avoid it,Proceedings of the World Medical Conference, WSEAS (26-28September 2011, Prague, Czech Republic), Prague, 2011, 79-84
• [55] Chrysant S.G., Chrysant G.S., The pleiotropic effects ofphosphodiesterase 5 Inhibitors on function and safety inpatients with cardiovascular disase and Hypertension, J ClinHypertense., 2012, 14(9), 644-649
• [56] Webb D.J., Freestone S., Allen M.J., Muirhead G.J., Sildenafilcitrate and blood-pressure-lowering drugs: results of druginteraction studies with an organic nitrate and a calciumantagonist, Am J Cardiol., 1999, 4, 83(5A), 21C-28C

Identifiers

DOI

10.1515/med-2015-0011