Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Amlodipine and enalapril promote distinct effects on
cardiovascular autonomic control in spontaneously
hypertensive rats: the role of aerobic physical training
Karina D. Maida, Suenimeire Vieira, Ada C. Gastaldi, Vanessa B. Bezerra,
Joa ˜ o E. De Araujo, and Hugo C.D. de Souza
Background: We compared the autonomic and
hemodynamic cardiovascular effects of amlodipine and
enalapril treatment associated with an aerobic physical
training program on spontaneously hypertensive rats.
Methods: Eighteen-week-old (n ¼ 48) spontaneously
hypertensive rats were assigned to one of two groups:
sedentary (n ¼ 24) and trained (n ¼ 24) through a 10-week
swimming training program. Each group was subdivided
into three groups (n ¼ 8): control (vehicle group),
amlodipine (amlodipine group; 10 mg/kg per day) and
enalapril (enalapril group; 10 mg/kg per day) (both for 10
weeks). We cannulated the femoral artery and vein of all
animals for recording arterial pressure and injecting drugs,
respectively. Autonomic assessment was performed by
double blockade with propranolol and atropine, analysis of
heart rate variability (HRV), systolic arterial pressure
variability and baroflex sensitivity.
Results: Arterial pressure reduction was more prominent
in the sedentary and trained enalapril groups. Amlodipine
sedentary group presented important autonomic
adjustments characterized by a predominance of vagal
tone in cardiac autonomic balance, increased HRV
associated with sympathetic autonomic modulation
reduction and increased vagal autonomic modulation, and
increased baroflex sensitivity. All findings were not
potentialized by physical training. In turn, the enalapril
trained group, but not its sedentary counterpart, also had
vagal tone prevalence in cardiac autonomic balance,
increased HRV, increased baroflex sensitivity and decreased
low-frequency band in systolic arterial pressure variability.
Conclusion: Amlodipine was more effective in promoting
beneficial autonomic cardiovascular adaptations in
sedentary animals. In contrast, enalapril achieved better
autonomic results only when combined with aerobic
physical training.
Keywords: amlodipine, cardiovascular autonomic control,
enalapril, hypertension, physical training, spontaneously
hypertensive rats
Abbreviations: ACE, angiotensin-converting enzyme; AP,
arterial pressure; bpm, beats per minute; BRS, baroreflex
sensitivity; DAP, diastolic arterial pressure; EF, ejection
fraction; FFT, fast Fourier transform; HF, high frequency;
HR, heart rate; HRV, heart rate variability; iHR, intrinsic
heart rate; LF, low frequency; LVEDD, left ventricular end-
diastolic diameter; LVEDV, left ventricular end-diastolic
volume; LVESD, left ventricular end-systolic diameter;
LVESV, left ventricular end-systolic volume; MAP, mean
arterial pressure; mmHg, millimeters of mercury; ms,
milliseconds; nu, normalized units; PI, pulse interval; PSD,
power spectral density; RRi, R-R interval; SAP, systolic
arterial pressure; SAPV, systolic arterial pressure variability;
SHR, spontaneously hypertensive rat; VLF, very low
frequency
INTRODUCTION
S
ystemic arterial hypertension is often accompanied
by damage to cardiovascular autonomic control
[1–3]. The condition is characterized by cardiac
autonomic imbalance caused by greater influence of the
sympathetic autonomic component and/or a reduction of
the vagal autonomic component [1–3]. A decrease in bar-
oreflex sensitivity (BRS) and impairment of the autonomic
modulation of heart rate variability (HRV) and systolic
arterial pressure variability (SAPV) are often identified
[1–3]. These autonomic alterations, if not reversed, can
lead to the evolution and aggravation of hypertension,
often accompanied by hemodynamic loss that can result
in early heart failure [1,4].
Therefore, numerous interventions have been recom-
mended to effectively treat hypertension. The most com-
mon includes a pharmacological approach using different
classes of antihypertensive drugs. Amlodipine, a calcium
channel blocker, and enalapril, an inhibitor of angiotensin-
converting enzyme (ACE), are among the most widely used
Journal of Hypertension 2016, 34:2383–2392
Exercise Physiology Laboratory, Ribeira ˜ o Preto Medical School, University of Sa ˜ o Paulo,
Ribeira ˜ o Preto, Sa ˜ o Paulo, Brazil
Correspondence to Hugo C.D. de Souza, PhD, Ribeira ˜ o Preto Medical School,
University of Sa ˜ o Paulo, Exercise Physiology Laboratory, Av. Bandeirantes, 3900, Vila
Monte Alegre, Ribeira ˜ o Preto 14049-900, SP, Brazil. Tel: +55 16 3315 4416;
fax: +55 16 3315 4413; e-mail: hugocds@fmrp.usp.br
Received 8 October 2015 Revised 25 June 2016 Accepted 10 August 2016
J Hypertens 34:2383–2392 Copyright ß 2016 Wolters Kluwer Health, Inc. All rights
reserved.
DOI:10.1097/HJH.0000000000001112
Journal of Hypertension www.jhypertension.com 2383
Original Article