From the Guidelines
Amlodipine does not significantly affect heart rate during exercise like running. Amlodipine is a calcium channel blocker primarily used to treat high blood pressure and certain types of chest pain by relaxing blood vessels, which improves blood flow and reduces the workload on the heart. Unlike beta-blockers (another class of blood pressure medications), amlodipine does not directly slow the heart rate at rest or limit the normal increase in heart rate that occurs during physical activity. This is because amlodipine works primarily on blood vessels rather than on the heart's electrical system or sympathetic response. Some patients might experience a slight reflex increase in heart rate when first starting amlodipine due to the blood pressure-lowering effect, but this is usually temporary and minimal. The study by 1 discusses the use of calcium channel blockers, including amlodipine, in diabetic patients, highlighting their effectiveness in reducing cardiovascular events, but it does not specifically address the effect of amlodipine on heart rate during exercise. If you're taking amlodipine and concerned about its effects during exercise, continue your normal running routine while monitoring how you feel, and discuss any unusual symptoms with your healthcare provider. Key points to consider include:
- Amlodipine's primary mechanism of action is on blood vessels, not the heart's electrical system
- It does not directly slow the heart rate at rest or during physical activity
- Any effect on heart rate is typically minimal and temporary
- Monitoring and discussion with a healthcare provider are recommended for any concerns during exercise.
From the FDA Drug Label
Although the acute intravenous administration of amlodipine decreases arterial blood pressure and increases heart rate in hemodynamic studies of patients with chronic stable angina, chronic oral administration of amlodipine in clinical trials did not lead to clinically significant changes in heart rate or blood pressures in normotensive patients with angina
These decreases in blood pressure are not accompanied by a significant change in heart rate or plasma catecholamine levels with chronic dosing
As with other calcium channel blockers, hemodynamic measurements of cardiac function at rest and during exercise (or pacing) in patients with normal ventricular function treated with amlodipine have generally demonstrated a small increase in cardiac index without significant influence on dP/dt or on left ventricular end diastolic pressure or volume
Amlodipine does not significantly affect heart rate while running, as it does not lead to clinically significant changes in heart rate with chronic dosing, and its effects on cardiac function during exercise are minimal. 2 2 2
From the Research
Effects of Amlodipine on Heart Rate While Running
- The study 3 found that amlodipine did not cause significant changes in heart rate in patients with essential hypertension, both at rest and during exercise.
- In contrast, the study 4 found that amlodipine caused a significant increase in mean resting heart rate in healthy volunteers, but did not alter the normal profile of resting or exercise-induced metabolic and hormonal responses.
- The study 5 found that amlodipine did not have a significant effect on exercise tolerance or heart rate in patients with heart failure and left ventricular systolic dysfunction.
- The study 6 found that amlodipine had a high antihypertensive effect in patients with metabolic syndrome, but did not have negative effects on heart rate variability.
- The study 7 found that amlodipine did not change heart rate variability parameters significantly in hypertensive patients with stable angina pectoris and isolated left ventricular diastolic dysfunction.
Key Findings
- Amlodipine may not have a significant effect on heart rate while running in patients with essential hypertension 3.
- Amlodipine may increase resting heart rate in healthy volunteers, but does not alter exercise-induced responses 4.
- Amlodipine may not have a significant effect on exercise tolerance or heart rate in patients with heart failure and left ventricular systolic dysfunction 5.
- Amlodipine has a high antihypertensive effect in patients with metabolic syndrome, without negative effects on heart rate variability 6.
- Amlodipine does not change heart rate variability parameters significantly in hypertensive patients with stable angina pectoris and isolated left ventricular diastolic dysfunction 7.