Disparate hemodynamic responses to mental challenge after antihypertensive therapy with beta blockers and calcium entry blockers |
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| Authors: | R E Schmieder H Rueddel H Neus F H Messerli A W Von Eiff |
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| Affiliation: | 1. Department of Medicine, University of Bonn, Bonn, Federal Republic of Germany;2. Department of Internal Medicine, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana, USA;1. Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy;2. Institute of Endocrinology, Catholic University School of Medicine, Rome, Italy;3. Institute of Otorhinolaryngology, Catholic University School of Medicine, Rome, Italy;4. Institute of Pathology, Catholic University School of Medicine, Rome, Italy;1. Instructor, East Nursing and Midwifery Care Research Center Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran;2. East Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran;3. Instructor, Department of Anesthesia, School of Paramedicine, Arak University of Medical Sciences, Arak, Iran;1. Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan;2. Department of Industrial Engineering and Management, Chaoyang University of Technology, Taichung, Taiwan;3. Department of Management Studies, Indian Institute of Technology (Indian School of Mines), Dhanbad, India;4. Southampton Business School, University of Southampton, Southampton, S017 1BJ, United Kingdom;1. Department of Chemical Engineering, Research Center for High Performance Polymer and Composite Systems (CREPEC), Polytechnique Montréal, 2900 Boulevard Edouard Montpetit, Montréal, Québec, H3T 1J4, Canada;2. Laboratory for Multiscale Mechanics (LM2), Department of Mechanical Engineering, Research Center for High Performance Polymer and Composite Systems (CREPEC), Polytechnique Montréal, 2900 Boulevard Edouard Montpetit, Montréal, Québec, H3T 1J4, Canada;3. From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118 and;4. the Department of Biological Sciences, University of Massachusetts Lowell, Lowell, Massachusetts 01854 |
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| Abstract: | The hemodynamic response to mental challenge was studied in 40 male outpatients with mild essential hypertension. The patients were treated randomly either with a beta adrenoreceptor blocker (oxprenolol) or with a calcium entry blocker (nitrendipine). Cardiovascular reactivity was evaluated with two different mental arithmetic tasks before and six months after treatment by continuously measuring systolic and diastolic pressure (ultrasonic Doppler device), heart rate (electrocardiography), and stoke volume (impedance cardiography). Patients in both treatment groups had equal decreases in arterial pressure and the same pressures at rest. In patients receiving calcium entry blockers, mental challenge provoked an increase in stroke volume and a decrease in total peripheral resistance similar to results in the pretreatment phase. In contrast, beta adrenoreceptor blockade reversed the hemodynamic response pattern to a distinct decrease in stroke volume (p less than or equal to 0.05) and an increase in total peripheral resistance (p less than or equal to 0.05). In addition, an attenuated heart rate response (p less than or equal to 0.01) and a larger increase in diastolic pressure (p less than or equal to 0.01) were found in the beta blocker group compared with the calcium entry blocker group. Although beta blockers and calcium blockers produce equal decreases in arterial pressure, beta blockers evoke an abnormal hemodynamic response to mental challenge, whereas calcium entry blockers preserve the physiologic reactivity pattern of the untreated state. |
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