Hemodynamic Normalization Shown after Treatment with Principal Antihypertensive Drugs in Essential Hypertension

概要

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The subjects were 105 essential hypertension patients (WHO stage 1〜2) in whom a hemodynamic analysis was performed by the Wezler-Boeger method before and after treatment (6〜12 weeks) with the Ca antagonists nifedipine and nicardipine, the ACEI captopril, and the β-blockers pindolol, bopindolol, and amosulalol. Based on its hemodynamic characteristics, the hypertension was classified into high-resistance or high-output, and the changes in these opposing hemodynamic conditions were observed. In high-resistance hypertension, a decrease in total peripheral resistance (TPR) and an increase in cardiac output (CO) occurred after treatment with all of the target drugs, and hemodynamic normalization occurred. By contrast, in high-output hypertension, the opposite occurred, CO decreased and TPR tended to increase, and hemodynamic normalization was observed. These changes seem to have occurred because of the unique hemodynamic effects of each of the drugs and to have depended on pressoreceptor resetting and homeostatic autoregulation of the body associated with the maintenance of optimal blood pressure reduction, and these findings indicated their hemodynamic usefulness. Improvement in the patients' QOL and prognosis can be expected by long-term maintenance of hemodynamic normalization.
北里大学の論文
1999-06-30