Effect of Amlodipine and of Nifedipine Retard on Autonomic Regulation of Heart Rate in Elderly Patients With Arterial Hypertension

Aim. To study the effect of the monotherapy with calcium channel blockers (amlodipine, 5 mg/d and nifedipine retard, 40 mg/d) on heart rate variability (HRV) in elderly hypertensive patients with different rate of biological ageing. Material and methods . 55 male hypertensive patients of 60-86 years with ischemic heart disease and chronic heart failure, class I-III (NYHA), were examined. Biological age was determined by the linear regression. HRV was determined by cardiointervalography and variation pulsemetry at the rest and in orthostatic test. Patients were split in to 2 groups (I - normal; II - fast ageing rate) and treated with the investigated drugs for 4 weeks. At the baseline and at the end of the study HRV and clinical blood pressure (BP) were determined. Results. Normal sympathetic activity and moderate overactivity was observed in patients of I group, and prominent sympathetic overactivity - in patients of II group. Monotherapy with amlodipine in patients of I and II groups improved indices of HRV (variation range, dispersion and stress index) and provided target BP reduction. Monotherapy with nifedipine retard in patients of I group elevated variation range, decreased stress index and provided target BP reduction. Sympathetic activity was not changed in patients of the II group. Autonomic regulation was normalized due to amlodipine and nifedipine retard therapy in patients of the both groups. Conclusion. The sympathetic overactivity is observed in elderly hypertensive patients. Monotherapy with calcium blockers improves HRV and provides target BP reduction.