Norvasc influence on the progression of atherosclerosis
Due to the presence of a number of reports of the possible beneficial effects of calcium antagonists on the state of the vascular endothelium was conducted multicenter, prospective, randomized, double-blind, placebo-controlled study was made. This study evaluated changes in the degree of atherosclerotic lesions of the coronary arteries and the thickness of the intima-medial layer of the carotid arteries on the background of the administration of amlodipine. The study was conducted on 825 patients with a confirmed using angiography coronary artery disease. Patients received amlodipine 5 mg increased to 10 mg in the case of good tolerability. The study was not obtained significant difference in both groups – the active treatment and control – against the progression of atherosclerotic coronary artery stenosis. On contrary, a marked effect of amlodipine on the progression of atherosclerosis in the carotid arteries is detected by ultrasonography. In the amlodipine group was observed regression intima-medial layer at 0,046 mm, and in the control group – a thickening at 0,011 mm. Currently, correlation between the degree of thickening of the intima-media layer of the carotid arteries with a frequency of myocardial infarction and stroke is proven fact. The study also shows a good tolerability that previously noted by other researchers, while the frequency of adverse reactions was comparable to the placebo group (79% for amlodipine and 83% for placebo). Additional administration of angiotensin-converting enzyme in the amlodipine group was observed in two times less than in the placebo group.
Undoubted advantage of amlodipine is a wide range of pharmacological effects, aimed at eliminating the symptoms of coronary insufficiency – antianginal, antihypertensive, anti-ischemic. The therapy with this drug is beneficial for patients with atherosclerosis.
Amlodipine has a greater selectivity for the coronary and cerebral vessels, practically devoid of inotropic effect and influence on the sinus node function and atrio-ventricular conduction, which determines its advantage over other drugs in clinical practice. Amlodipine advantageous difference from earlier calcium antagonists considered his lack of influence on the heart rate, which increase during exercise is one of the triggers of ischemia. In addition, the drug was well tolerated. Calcium channel blockers may be used for vasospastic angina related obstructive pulmonary diseases. An additional indication for calcium antagonists is Raynaud’s syndrome.
Among the side effects are the possibility of the development of edema and shins hyperemia that is common to all dihydropyridine drugs. Sudden cessation of amlodipine administration does not cause withdrawal syndrome.
Thus, amlodipine is a fundamental drugs for the treatment of hypertension and angina. The drug is very effective and well tolerated. Dihydropyridine group of calcium antagonists with prolonged action are indicated in patients with stable angina and elderly patients. Other beneficial effects of CCB for patients with CHD and hypertension are antiatherogenic, antiproliferative, antiplatelet. Single dose of Amlodipine provides uniform control of blood pressure and is well tolerated. CCB with prolonged action are recommended for long-term treatment of angina pectoris as compared with others dihydropyridine derivatives.