Document Detail

Comparison of verapamil versus felodipine on heart rate variability in hypertensive patients.
MedLine Citation:
PMID:  10403616     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We evaluated the effect of two calcium channel blockers, verapamil and felodipine, on heart rate variability in hypertensive patients. DESIGN: Time and frequency domain measures of heart rate variability were obtained from 24 h Holter recording in 25 previously untreated hypertensive patients without left ventricular hypertrophy, before and after 3 months of verapamil slow-release treatment (240 mg once daily) or felodipine extended-release treatment (10 mg once daily). RESULTS: Blood pressure values decreased with both drugs. Measures of heart rate variability, comparable at baseline in the two groups, were unchanged after felodipine. After verapamil, the average RR interval, the square root of the mean of the squared differences between all adjacent normal RR intervals (r-MSSD) and the percentage of differences between all adjacent normal RR intervals > 50 ms (pNN50), measures of vagal modulation of heart rate, increased (from 735 +/- 67 to 827 +/- 84 ms, P < 0.001; from 30 +/- 10 to 44 +/- 15 ms, P < 0.001; and from 3 +/- 2 to 7 +/- 6%, P < 0.01, respectively) and were higher than after felodipine. The coefficient of variation, a measure that compensates for heart rate effects, increased only after verapamil (from 5.8 +/- 1.3% to 6.6 +/- 1.0%; P < 0.05). High frequency power and its coefficient of component variance, both representing the vagal modulation of heart rate, increased after verapamil (from 5.33 +/- 0.29 to 5.80 +/- 0.27 In units, P < 0.001 and from 1.9 +/- 0.3 to 2.2 +/- 0.25%; P < 0.05). Finally, the low to high frequency power ratio, an indicator of sympathovagal balance, with a high value suggesting a sympathetic predominance, decreased after verapamil (from 2.16 +/- 0.41 to 1.36 +/- 0.35; P < 0.001), confirming the improvement in vagal modulation of heart rate. CONCLUSION: In hypertensive patients, despite a comparable anti-hypertensive effect, verapamil, but not felodipine, has favourable effect on cardiac autonomic control.
M Petretta; V Canonico; A Madrid; M Mickiewicz; L Spinelli; F Marciano; A Vetrano; A Signorini; D Bonaduce
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of hypertension     Volume:  17     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-10-19     Completed Date:  1999-10-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  707-13     Citation Subset:  IM    
Institute of Internal Medicine, Cardiology and Heart Surgery, University of Naples Federico II, Italy.
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MeSH Terms
Blood Pressure / drug effects
Calcium Channel Blockers / pharmacology*
Delayed-Action Preparations
Felodipine / pharmacology*
Heart Rate / drug effects*
Hypertension / drug therapy,  physiopathology*
Middle Aged
Single-Blind Method
Time Factors
Verapamil / pharmacology*
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Delayed-Action Preparations; 52-53-9/Verapamil; 72509-76-3/Felodipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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