Tiwaskar Mangesh, Langote Amit, Kashyap Resham, Toppo Archana
Consultant Physician and Diabetologist, Asian Heart Institute, Mumbai, Maharashtra.
Consultant Nephrologist and Transplant Physician, Apollo Hospital, Nerul, Navi Mumbai, Maharashtra.
J Assoc Physicians India. 2018 Mar;66(3):64-9.
Amlodipine is a classical drug with varied properties extending from control of blood pressure to as an antianginal and anti atherosclerotic agent. Amlodipine is a longer acting dihydropyridine calcium channel blocker, effective for 24 hours BP control and cause no BP variability. It is a powerful, well-tolerated, and safe antihypertensive agents that is widely used either alone or as a key component of combination therapy for hypertension. Its effective BP reduction has shown proven benefits in cardiovascular event reduction that is supported with strong evidences from large randomised controlled trials. Combination therapies of amlodipine with other agents eliciting renin-angiotensin-aldosterone system blockade (angiotensin II receptor blockers or renin inhibitors) have shown effective blood pressure-lowering strategies in CV risk reduction and progression of renal disease. Novel type of calcium channel blockers have been developed which have additional properties of blocking T and N subtypes of calcium channels and apart from their class effects they exerts specific action on heart rate and renin aldosterone system. They are considered to be more renoprotective due to this additional properties. Amlodipine is most potent and longer acting agent compared to the newer CCBs, its effectiveness in BP lowering still makes it the agent of choice among all the CCBs.
氨氯地平是一种经典药物，具有多种特性，从控制血压到作为抗心绞痛和抗动脉粥样硬化药物。氨氯地平是一种作用时间更长的二氢吡啶类钙通道阻滞剂，对血压控制有效24小时，且不会引起血压波动。它是一种强效、耐受性良好且安全的抗高血压药物，广泛单独使用或作为高血压联合治疗的关键组成部分。其有效的血压降低已在减少心血管事件方面显示出已证实的益处，这得到了大型随机对照试验的有力证据支持。氨氯地平与其他引起肾素-血管紧张素-醛固酮系统阻断的药物（血管紧张素II受体阻滞剂或肾素抑制剂）的联合治疗已显示出在降低心血管风险和延缓肾脏疾病进展方面有效的降压策略。已经开发出新型钙通道阻滞剂，它们具有阻断钙通道T和N亚型的额外特性，除了其类效应外，还对心率和肾素醛固酮系统发挥特定作用。由于这种额外特性，它们被认为具有更强的肾脏保护作用。与新型CCB相比，氨氯地平是最有效的且作用时间更长的药物，其在降低血压方面的有效性仍然使其成为所有CCB中的首选药物。
