Drug safety evaluation of amlodipine

INTRODUCTION: Despite the availability of a wide range of antihypertensive medications, in European countries the number of patients not reaching blood pressure control target varies from 59.7% in England to 81.3% in Spain demonstrating substantial unmet need in the effective treatment of arterial hypertension. AREAS COVERED: The authors conducted a review analyzing clinical efficacy and safety of amlodipine, both alone and in combination with other antihypertensive drugs, including the most important studies about amlodipine in the last 15 years. Readers will have a clearer idea of the use of amlodipine, its indications and contraindications, and they will know if amlodipine is a better or worse choice compared to the other antihypertensive drugs. EXPERT OPINION: Amlodipine is not inferior to the other antihypertensive drugs in reducing hypertension and has additional biological effects that are not mediated through blood pressure reduction, including antioxidant activity, inhibition of smooth muscle cell proliferation and enhancement in endothelial NO production. Amlodipine, besides being effective on left ventricular hypertrophy, appears beneficial in slowing down the progression of carotid hypertrophy and atherosclerosis, and can be used in patients with angina pectoris, even if the first choice for angina treatment is β-blockers.