Journal of cardiovascular pharmacology
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J. Cardiovasc. Pharmacol. · Jan 1988
Review Comparative StudyHemodynamic effects of beta-blocking compounds possessing vasodilating activity: a review of labetalol, prizidilol, and dilevalol.
The cardinal hemodynamic disturbance in established essential hypertension is an increased total peripheral resistance. Monotherapy with conventional beta-blockers lowers blood pressure usually without any significant fall in total peripheral resistance. Generally, cardiac output is reduced at rest as well as during exercise. ⋯ Preliminary data indicate a reduction in blood pressure--mainly due to a fall in total peripheral resistance. Studies in elderly patients or in patients with reduced left ventricular function seem to indicate that the drug might be used without deterioration of the heart pump function. Although antihypertensive properties of dilevalol have been extensively studied and are defined, the exact position of dilevalol among antihypertensive drugs will be more precisely determined in future studies.
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J. Cardiovasc. Pharmacol. · Jan 1988
ReviewVascular reactivity, adrenergic mechanisms, and arteriolar resistance in hypertension.
Hypertension, both essential and experimental is characterised by increased vascular resistance. This is in part structural, due to increases in the wall-to-lumen ratio secondary to vascular hypertrophy; however, functional increases in responses to neurohumoral stimuli also occur. The latter may be a consequence of hypertrophy or if a selective increase is observed, an indication of a primary underlying hypertensive mechanism. ⋯ However, in some experimental models, more selective increased responses have been reported. The mechanism of alpha-adrenoceptor-mediated vascular smooth muscle contraction is reviewed and the role of inositol phosphates and diacylglycerol as second messengers is discussed. The precise mechanism of increased vascular responses in hypertension is still uncertain.
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J. Cardiovasc. Pharmacol. · Jan 1988
Randomized Controlled Trial Clinical TrialTreatment of hypertensive urgencies and emergencies with nitrendipine, nifedipine, and clonidine: effect on blood pressure and heart rate.
Nitrendipine is a new calcium antagonist of the 1,4-dihydropyridine group with strong vasodilating properties. In a randomized trial involving 45 patients, whose mean blood pressure was 236 +/- 24/129 +/- 21 mm Hg, 5 mg nitrendipine (given sublingually via a phiole) was compared with 20 mg nifedipine (given sublingually via two pierced 10-mg capsules) and 0.15 mg clonidine (given intravenously). Blood pressure and heart rate were assessed for 8 h after intake of the antihypertensive agents. ⋯ Main side effects were observed in the nifedipine group (flush and reflex tachycardia) and in the clonidine group (dry mouth and drowsiness). In conclusion, nitrendipine, nifedipine, and clonidine show similar efficacy in the treatment of hypertensive urgencies and emergencies. However, sublingual application of the calcium antagonists is simple and safe; moreover, nitrendipine is better tolerated than nifedipine and clonidine.
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J. Cardiovasc. Pharmacol. · Jan 1988
24-hour noninvasive oscillometric blood pressure monitoring: evaluation of the antihypertensive circadian profile of nitrendipine.
The understanding of blood pressure (BP) and heart rate (HR) variation, circadian changes, and the responses to nonclinical situations has been improved by automated ambulatory recordings. The antihypertensive efficacy of a once-daily regimen (10/20 mg) of nitrendipine was evaluated in detail using the lightest available portable device equipped with an oscillometric blood pressure (BP) recorder (SpaceLabs 90202, weight 480 g) devoid of any electrode. A good antihypertensive effect throughout the day in 20 outpatients could be demonstrated. No significant change of BP could be found in early morning and wake-up period; HR was not significantly affected after 6 weeks of oral therapy.