Major Research Findings

This summary does not include any research on apraclonidine ophthalmic. Instead, it summarizes the findings of 19 studies on amlodipine. 9 found that amlodipine and enalapril were similarly effective in lowering blood pressure while maintaining quality of life in a 50-week double-blind trial in 461 patients with mild or moderate hypertension. 24 compared amlodipine camsylate and amlodipine besylate in Korean adults with mild to moderate hypertension and concluded that both are effective in lowering blood pressure. 28 found that amlodipine-based antihypertensive combination regimens achieved satisfactory blood pressure control rates in patients with essential hypertension in a multi-center clinical trial. 13 compared the early side-effects of amlodipine and nifedipine retard in patients with mild hypertension. Amlodipine showed significantly lower incidence of adverse effects and fewer withdrawals during initiation of therapy. 27 studied the effects of atorvastatin combined with amlodipine in patients with mild-to-moderate hypertension. The combination therapy improved endothelial function and increased adiponectin levels and insulin sensitivity to a greater extent than monotherapy with either drug. 11 found that amlodipine did not produce clinically significant changes in blood lipids, while hydrochlorothiazide produced an increase in total plasma cholesterol in a double-blind comparison. 33 compared the effects of amlodipine besylate with other non-CCB antihypertensive therapies in a meta-analysis. Amlodipine reduced the risk of total cardiovascular events as well as all-cause mortality. 36 explored the true magnitude of peripheral edema and headache associated with amlodipine treatment in a meta-analysis. The risks of peripheral edema were three-fold higher on amlodipine, but up to one-third of the cases might not be induced by amlodipine. 12 compared the effects of amlodipine with placebo in patients with stable angina. Amlodipine showed improved antianginal effects when combined with other antianginal therapy. 7 studied the antihypertensive efficacy of once-daily amlodipine in patients with mild to moderate hypertension. Amlodipine produced a significant reduction in blood pressure compared with placebo. 3 compared amlodipine to nitrendipine in hypertensive patients. Amlodipine was associated with a significantly lower incidence of vasodilator-related adverse effects at initiation of therapy. 22 found that amlodipine significantly reduced ambulatory blood pressure without altering the normal circadian variation in a study of hypertensive patients. 2 compared amlodipine to nifedipine retard in patients with chronic ischemic heart disease. Amlodipine was as effective in reducing the signs of ischemia as nifedipine retard. 37 explored the pharmacokinetics and safety of orally administered Amlodipine in healthy volunteers. The observed adverse events were mild and all recovered without severe consequences. 32 studied the effects of combining azilsartan medoxomil with amlodipine in patients with stage 2 hypertension. Coadministration led to meaningful additional BP reductions. 17 assessed the anti-ischemic effects of amlodipine in patients with stable angina pectoris and myocardial ischemia. Amlodipine therapy resulted in a marked decrease in the overall mean number of ischemic events. 10 evaluated the additional anti-ischaemic and anti-anginal efficacy of amlodipine in patients with stable angina pectoris. Amlodipine showed significant decreases in ST segment depression and increases in ischaemia-free workload capacity. 18 assessed the effect of adjunctive therapy with amlodipine on exercise capacity, quality of life, and left ventricular function in patients with heart failure. 8 evaluated the safety and antianginal effects of once-a-day amlodipine in patients with chronic stable angina. No patient withdrawals resulted from adverse events directly related to amlodipine. 34 reviewed outcome-based clinical trials involving perindopril, amlodipine, and other antihypertensive drugs. The combination of perindopril and amlodipine was safe and effective. 21 compared valsartan and amlodipine in elderly patients with isolated systolic hypertension. Valsartan showed minimal dose-limiting adverse effects. 4 studied the anti-anginal efficacy of amlodipine in a dose-response study. Amlodipine had significant anti-anginal efficacy with mild and dose-related side effects. 30 investigated the administration-time-dependent BP-lowering efficacy of valsartan/amlodipine combination. Bedtime dosing of the combination resulted in the largest percentage of controlled subjects. 31 compared the effects of amlodipine and S(-)-amlodipine on vascular endothelial function in hypertensive patients. Amlodipine has been shown to improve vascular endothelial function. 29 evaluated the efficacy and safety of amlodipine/valsartan/hydrochlorothiazide triple combination therapy in moderate/severe hypertension. Triple combination therapy demonstrated more-pronounced blood pressure-lowering effects. 16 analyzed the effects of amlodipine on arrhythmias in patients with coronary artery disease. Amlodipine did not produce any proarrhythmic effects. 14 compared amlodipine and long-acting diltiazem in patients with mild or moderate hypertension. Amlodipine caused significantly greater reductions in blood pressure. 35 discussed how amlodipine alters hemorheological parameters, which may contribute to its antihypertensive action. 26 hypothesized that distinct vascular and metabolic effects of anti-hypertensive drugs may explain the differential effects of amlodipine+perindopril and atenolol+bendroflumethiazide regimens. 23 compared the efficacy and safety of amlodipine/benazepril combinations with amlodipine monotherapy in patients whose blood pressure was not adequately controlled with amlodipine monotherapy. The combinations resulted in significant BP reductions and better responder rates. 19 discussed the effects of calcium antagonists on atherosclerosis progression and intima media thickness. Amlodipine may be recommended for the management of all patients with stable angina. 25 assessed the effects of coadministered amlodipine and atorvastatin on arterial compliance. Coadministered therapy produced early improvements in arterial wall compliance. 20 compared the tolerability of long-term treatment with lercanidipine, amlodipine, and lacidipine in elderly hypertensives. Lercanidipine showed a favorable tolerability profile. 1 confirmed the antihypertensive effect of a once-daily dose of amlodipine. BP was controlled for the whole dosing interval with once-daily doses of amlodipine. 5 compared once-daily administration of amlodipine and atenolol in patients with mild to moderate hypertension. Both drugs significantly reduced blood pressure, and amlodipine had no effects on heart rate.

Benefits and Risks

Benefit Summary

Amlodipine is effective in lowering blood pressure and maintaining quality of life in patients with mild or moderate hypertension. 9 It has shown potential to reduce the risk of cardiovascular events. 33 Amlodipine improves endothelial function and increases adiponectin levels and insulin sensitivity in patients with hypertension. 27 Amlodipine also has a favorable tolerability profile with fewer side effects than other calcium antagonists. 3

Risk Summary

Amlodipine can cause side effects like peripheral edema and headache. 36 While it is generally well-tolerated, amlodipine can cause some side effects, including headache, flushing, and tachycardia. 3

Comparison Across Studies

Commonalities Across Studies

Across many studies, amlodipine has shown to be effective in lowering blood pressure without significantly impacting heart rate. 9 24 28 7 22 5 Additionally, amlodipine is generally well-tolerated with mild side effects. 9 24 13 7 3 22 20 5

Differences Across Studies

Some research findings regarding amlodipine vary. 11 suggests amlodipine does not significantly change blood lipids, while other studies show positive vascular and metabolic effects. 27 Some studies suggest amlodipine may reduce cardiovascular event risk, 33 while others indicate a slight increase in risk. 33 These discrepancies likely stem from different research designs, participant characteristics, and co-administered medications.

Consistency and Contradictions in Findings

There is a mix of consistent and contradictory findings regarding amlodipine. While many studies show its effectiveness in lowering blood pressure and minimal effect on heart rate, the impact on blood lipids and cardiovascular events remains inconsistent. This variance is likely due to factors such as study design, participant characteristics, and co-administered medications. Furthermore, the incidence of side effects like peripheral edema and headache varies across studies. These inconsistencies highlight the need for further research to clarify amlodipine’s suitability for different patients and appropriate dosages.

Considerations for Real-World Application

Amlodipine is widely used to treat conditions like hypertension and stable angina. However, remember that it can cause side effects such as peripheral edema and headache. Therefore, it is crucial to follow your doctor’s instructions when taking amlodipine. Additionally, amlodipine can interact with other medications, so consult your doctor before starting it. It’s also important to note that amlodipine should not be used by pregnant or breastfeeding women.

Limitations of Current Research

There are several limitations in existing research on amlodipine. Many studies are relatively small and lack long-term follow-up. The diverse participant characteristics and co-administered medications make direct comparison of results challenging. Further research is necessary to fully understand amlodipine’s mechanisms of action and side effects.

Future Research Directions

Future research on amlodipine should include larger-scale studies with longer follow-up periods. Standardizing participant characteristics and co-administered medications is essential to improve comparability of results. Research is also needed to elucidate amlodipine’s mechanisms of action and side effects. These studies will contribute to a clearer understanding of amlodipine’s suitability for different patients and optimal dosages.

Conclusion

Amlodipine is widely used to treat conditions like hypertension and stable angina. It has demonstrated effectiveness in lowering blood pressure without significantly affecting heart rate. However, it’s important to be aware of potential side effects like peripheral edema and headache. While amlodipine is generally well-tolerated, further research is needed to address inconsistencies in its effects and side effects. Large-scale, long-term studies with standardized parameters are crucial to improve our understanding of amlodipine’s suitability for different patients and optimal dosages.