POSSIBLE SIGNIFICANCE OF THE PHARMACOLOGICAL DIFFERENTIATION OF BETA-BLOCKING AGENTS IN HEMODYNAMIC EFFECTS IN ESSENTIAL HYPERTENSION

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概要

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• Thirteen beta-blocking agents with different pharmacological properties were administered orally to 161 outpatients with essential hypertension for 5 weeks to assess their hemodynamic effects. Cardioselective ones, such as atenolol, metoprolol and acebutolol, reduced mean blood pressure (MBP) and the cardiac index (CI) without any changes of the total peripheral resistance index (TPRI). In the total 44 patients treated with these drugs, a positive correlation (r=0.529, p < 0.005) was found between the decrease in MBP and that of TPRI, but the decrease in MBP did not correlate with that of CI. Effects of non-cardioselective ones were classified arbitrarily into the following 3 patterns : 1) reduction of CI of more than 0.50 L/min/m^2 and a slight increase of TPRI by more than 150 dyne・sec・cm^<-5>・m^2 (nadolol, propranolol, oxprenolol and penbutolol), 2)reduction TPRI by more than 150 dyne・sec・cm^<-5>・m^2 (pindolol, bunitrolol and labetalol) and 3) the intermediate hemodynamic responses between the two patterns described above (carteolol, bupranolol and bufetolol). In all these 3 groups, the decrease in MBP correlated with that of TPRI (O the first group, n=45, r=0.557, p < 0.005 ; the second, n=37, r=0.525, p < 0.005 ; the third, n=35, r=0.612, p<0.005), but did not correlate with the decrease of CI. These results suggest that the antihypertensive effects of beta-blocking agents mainly depend on the reduction of peripheral resistance, although their pharmacological properties are not uniform and their cardiodepressant effects are variable. Reduction of cardiac performance with these beta-blocking agents seemed to be a consequence of overall pharmacological actions including beta-receptor blockade, central effects and membrane stabilizing effects, and it may be antagonized by intrinsic sympathomimetic activity and the reduction in afterload for the heart. Vascular beta-receptor blocking action may play a part in decreasing the degree of reduction of the total peripheral resistance index, while their intrinsic sympathomimetic action on the vascular site may induce vasodilating effects.

• 社団法人日本循環器学会の論文
• 1983-03-20

著者

• NAKAMURA Yutaka

  Department of Industrial and Systems Engineering, Setsunan University

• Yamamoto Youichi

  Kanagawa Prefectural Hospital Center for the Adults.

• Otsuka Keiko

  Department of Bioscience and Biotechnology, Faculty of Agriculture, University of the Ryukyus

• Otsuka Keiko

  Department Of Cardiovascular Diseases Kanagawa Medical Center For Adults

• Otsuka Keiko

  2nd Dept Of Int. Med. Yokohama City Univ. School Of Medicine.

• Horii Masako

  Department Of Cardiovascular Diseases Kanagawa Medical Center For Adults

• Horii Masako

  Dept. Of Int. Med. Dept. Of 2nd Radiology

• Yoshii Yuzuru

  Department Of Cardiovascular Diseases Kanagawa Medical Center For Adults

• Yamamoto Yooichi

  Department Of Radiology Kanagawa Medical Center For Adults

• Tsukiyama Hisaichiro

  Department Of Cardiovascular Diseases Kanagawa Medical Center For Adults

• Tsukiyama Hisaichiro

  2nd Dept Of Int. Med. Yokohama City Univ. School Of Medicine.

• Tsukiyama Hisaichiro

  Department Of Cardiovascular Disease Kanagawa Cancer Center

• Ohtsuka Keiko

  2nd Dept Of Int. Med. Yokohama City Univ. School Of Medicine.

• Hatori Yutaka

  Department Of Cardiovascular Diseases Kanagawa Medical Center For Adults

• Hoshino Masanobu

  Second Department Of Internal Medicine Yokohama City University School Of Medicine

• Otsuka Keiko

  2nd Department Of Internal Medicine Yokohama City University School Of Medicine

• Tsukiyama Hisaichiro

  2nd Department Of Internal Medicine Yokohama City University School Of Medicine

• NEMOTO EIICHIRO

  Department of Radiology, Kanagawa Medical Center for Adults

• YAMATO TORAAKI

  Department of Radiology, Kanagawa Medical Center for Adults

• SAKAI TOSHIKO

  Department of Radiology, Kanagawa Medical Center for Adults

• Yamato Toraaki

  Department Of Radiology Kanagawa Medical Center For Adults

• Otsuka Keiko

  Department Of Bioscience And Biotechnology Faculty Of Agriculture University Of The Ryukyus

• Sakai Toshiko

  Department Of Radiology Kanagawa Medical Center For Adults

• Nemoto Eiichiro

  Department Of Radiology Kanagawa Medical Center For Adults

• Tsukiyama Hisaichiro

  2nd Dept. Of Intern. Med. Yokohama Univ. School Of Med.

• Nakamura Yutaka

  Department Of Animal Sciences Ibaraki University

• Otsuka Keiko

  Dept. Of Intern. Med. Yokohama City Univ.

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