Antihypertensive and pleiotropic activity of the calcium antagonist amlodipine in patients with arterial hypertension and obesity

The goal lies in the study of amlodipine effects on levels of blood pressure (BP), hypertensive reaction under isometric exercise, lipid and carbohydrate metabolism, platelet hemostasis, quality of life (QoL) and psychological status in patients with arterial hypertension (AH), obese abdominal type. Material and methods. The study included 30 patients with hypertension of the 1st and 2 nd degree in age from 37 to 72 years (mean age 56.6±7.9 years) with abdominal obesity type. After a 2-week period "cleanse" of patients, amlodipine was administered at an initial dose of 5 mg, with an increase up to 2 weeks in the absence of 10 mg of achieving target blood pressure (less than 140/90 mm Hg). The total duration of treatment took 6 weeks. In a study conducted, the clinical examination and ambulatory BP monitoring were also included, and a manual isometric test was taken, to determine the concentration of lipids and lipoproteins, glucose and insulin platelet aggregation (spontaneous and under the influence of adenosine acid) was evaluated, as well as adrenaline in different concentrations. The questionnaires on quality of life, Hospital Anxiety and Depression Scale were used as well. Results. Against the background of 6 weeks of therapy with amlodipine, a decrease in blood pressure levels, as measured by the patient in a sitting position (21.7±8.2/12.3±4.6 mm Hg, p<0.001) and in the standing position (19.8±6.9/11.5±5.5 mm Hg, p<0.001). Appointment of amlodipine to patients with hypertension obesity has led to positive changes in the diurnal blood pressure profile. This was combined with a decrease in the heart rate of the patient in the sitting position (at 4.2±6.4 beats / min, p=0.002) and standing (at 2.6±5.9 beats/min, p=0.03). After 6 weeks of receiving amlodipine at the peak of isometric exercise were detected decrease in average blood pressure levels (20.2±11.6/10.2±5.2 mm Hg, p<0.001), heart rate (at 4.2±6.6 beats / min, p=0.002) and the value of the "double work" (30.2%, p<0.05). In response to isometric exercise there was a decrease in diastolic blood pressure level of growth (6.9%, p=0.012) and the value of the "double work" (21.9%, p<0.05). The therapy with amlodipine was observed decrease in total cholesterol and low density lipoprotein cholesterol. The concentration of blood glucose and insulin therapy remained stable. There was a positive trend to a decrease in platelet aggregation under the action of adenosine. QoL in patients with hypertension and obesity was significantly improved after 6 weeks of receiving amlodipine. Conclusion. In patients with hypertension and obesity demonstrated high antihypertensive efficacy of amlodipine, including the conditions of isometric exercise, inducing hypertensive reaction.

arterial hypertension, obesity, isometric exercise, blood pressure, amlodipine