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Abstract
This is a prospective, community based, single blind, monocentric, clinical study performed in a community based health care centre, Chatkhil, Noakhali for the period from June 23, 2006 to September 21, 2008. Patients of hypertension & IHD (chronic stable angina) were selected for study, age limit 20-80 years, both genders were included; sample size 507. The prime objective is to study the efficacy of amlodipine on left ventricular function on hypertension & ischaemic heart disease. Patients were evaluated clinically & then investigated by X-Ray, ECG, Echocardiography. Amlodipine therapy (5 mg daily) was given with or without other medications followed by echo-evaluation of LV function for 9-12 months LV-EF & LV mass/BSA were measured very accurately. Among 507, male 355 (70.01%) & female 152 (29.98%). 50-59 years age group was affected much (210 cases, 41.42%). Second affected age group is 60-69 years (107 cases, 21.10%). Service holders & businessmen were affected much (135 cases- 26.62%, 134 cases- 26.42%). Normal LV-EF was observed in 95 (18.73%) & 114 cases (23.26%) before & after drug therapy. Besides normal LV mass/BSA was observed in 50 (9.86%) & 67 (13.67%) cases respectively before & after treatment. So it is concluded that amlodipine, a third generation CCB effectively control BP, helps in regression of LV hypertrophy & thus improves LV function (LV-EF).

Key words
Amlodipine, LV function, echocardiography

Introduction
Calcium (Ca⁺⁺) is required for contraction of cardiac & smooth muscle, also responsible for propagation of Cardiac impulse, Calcium channel blockers (CCBs) block the influx of calcium into cells. This relaxes the muscles in the walls of arteries resulting in dilatation.¹ This lowers the blood pressure and improves the blood supply to the heart muscle. All of these effects allow the heart to work with reduced blood supply together with relief of anginal pain.²

Calcium Channel Blockers (CCBs) may be divided into benzothiazepine (diltiazem); phenylalkylamine (verapamil); and dihydropyridines (first generation: Nifedipine, nicardipine, felodipine, nisoldipine; second generation: isradipine, nimodipine; third generation: amlodipine, lacidipine etc).

Amlodipine is a third generation CCB with long half-life. It has interaction with specific high affinity binding sites in the calcium channel complex. It maintains therapeutic efficacy throughout 24 hours. It has less negative inotrophic and chronotrophic action, having lack of clinically, relevant increase in cardiac or peripheral sympathetic activity. It has higher lipophilicity; reflex tachycardia is minimal, relatively safe in heart failure.³

The L-type calcium channel is the dominant type in cardiac & smooth muscle. The calcium channel blockers act from the inner side of the membrane and bind more effectively to channels in depolarizing membranes.

In the cardiac myocyte, Ca⁺⁺ binds to troponin and reduces inhibitory effects of troponin on contraction, favouring muscle contraction. CCBs reduce transmembrane movement of Ca.⁺⁺ reduce the amount reaching intracellular sites and therefore reduce vascular smooth muscle tone.

Amlodipine has got minimal or no effect on AV conduction.⁴

CCBs have direct negative inotrophic effects and showed some benefits on haemodynamic parameters alone or in combination with ACE inhibitors. Amlodipine has got potentially beneficial effects on hypertension and coronary artery disease specially stable angina. But amlodipine showed minimal beneficial effects in patients with heart failure which was observed on large, randomized, placebo-controlled trials.⁵

Aims and objectives
The objectives were-

1. To study the efficacy of amlodipine on left ventricular function in hypertension.
2. To study the efficacy of amlodipine on left ventricular function in ischaemic heart disease (stable angina).
3. To evaluate any side effects of amlodipine used for HTN & stable angina.
4. Echocardiographic evaluation of LV function after amlodipine therapy in HTN & IHD.
5. Finally to provide some new information on amlodipine therapy in this regard.

Materials and methods

It is a prospective, community based, single blind, mono-centric, clinical study performed in a Community Health Care Centre, Chatkhil, Noakhali from 23.06.2006 to 21.09.2008.

A larger geographical area of Noakhali district i.e. Chatkhil, Sonaimuri, Begumgonj and part of Lakhipur and Comilla districts were fairly covered in this study.

All patients attending the OPD were screened. Patients of hypertension & IHD (stable angina) were selected for study. Age limit was 20-80 years; no gender variation; Associated heart failure was not a contraindication for inclusion. Consent was taken from all patients or relatives prior entry to study.

After clinical case selection, patients were investigated by X-ray, ECG, Echo, & for blood glucose and lipid profile. Then amlodipine therapy (5 mg daily) was given with other