狭心症患者における長時問作用型Ｎｉｆｅｄｉｐｉｎｅ徐放性製剤の心拍数および自律神経活動に及ぼす影響

Abstract

The effects of controlled release nifedipine (nifedipine CR) on heart rate and the autonomic nervous system were investigated over a 12-week administration period in 19 patients with ischemic heart disease (17 males and 2 females, mean age 64 years) using spectral analysis of heart rate variability. No notable changes were found in the treatment period compared to the pre-treatment period in the low frequency (LF) or high frequency (HF) spectra or in the LF/HF ratio obtained from Holter monitor recording. The HF component is an index of vagal activity, while the LF component is an index of sympathetic activity with vagal modulation. The LF/HF ratio is thus considered to reflect sympathetic modulation. The results of spectral analysis of heart rate variability showed that nifedipine CR did not enhance sympathetic nervous activity, nor reduce vagal activity, indicating that nifedipine CR does not affect the autonomic nervous system. In addition, the drug had no effect on heart rate. An increase in heart rate and changes in the autonomic nervous system are negative factors associated with short-acting nifedipine in the long-term prognosis. The results of this study show that these adverse factors can be avoided by the use of a controlled release system.The data therefore suggest that the nifedipine CR tablet (Adalat ® CR tablet) is clinically more favorable than former nifedipine formulations, owing to the decreased load on the heart.