Comparative Effects of Amlodipine Monotherapy and Combination Therapy With Betaxolol on Cardiac Autonomic Nervous Activity and Health-Related Quality of Life in Patients With Poorly Controlled Hypertension

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• Background The aim of the study was to evaluate whether the combined treatment of calcium channel blocker, amlodipine and /3-blocker, betaxolol, favorably affects cardiac autonomic nervous activity (CANA) and health-related quality of life (HRQL). Methods and Results A total of 65 patients with a poor blood pressure (BP) control with a low dose amlodipine therapy were randomly assigned to the amlodipine dose-up group (n=21) and betaxolol adding group (n=44). Before and after a 6-month treatment, BP, heart rate variability (HRV), HRQL and blood chemistries were evaluated. Low frequency (LF) spectra/high frequency (HF) spectra and HF/total power spectra (TP) were calculated as indexes of CANA, and HRQL was assessed by the questionnaire sheets. BP was well controlled in all patients of the present study. In the betaxolol adding group, LF/HF decreased (2.1±1.9 to 1.3±0.9, p<0.05) and HF/TP re-ciprocally increased (0.41±0.17 to 0.52±0.18, p<0.05), whereas the amlodipine dose-up group showed no significant changes in the HRV. HRQL was significantly improved in the betaxolol adding group, whereas it remained unchanged in the amlodipine dose-up group. Blood chemistries remained unchanged except for the slightly increased plasma brain natriuretic peptide concentrations in the betaxolol adding group (36±47 to 62±62pg/ml, p<0.05). Conclusions Combined treatment of amlodipine and betaxolol appears to be more useful than amlodipine dose-up therapy, because combined treatment improves CANA and HRQL.

• 社団法人日本循環器学会の論文
• 2008-04-20

著者

• Yamamoto Takeshi

  Department Of Medicine And Clinical Science Division Of Cardiology Yamaguchi University Graduate Sch

• Fujita Masatoshi

  Kyoto University

• Uzui Hiroyasu

  University Of Fukui

• Lee Jong-dae

  University Of Fukui

• Tarutani Yasuhiro

  Division Of Cardiology Department Of Medicine Kohka Public Hospital

• Takase Bonpei

  National Defense Medical College

• Hirai Tadakazu

  Second Department Of Internal Medicine University Of Toyama

• Miwa Kunihisa

  Second Department Of Internal Medicine Toyama Medical And Pharmaceutical University

• Miwa Kunihisa

  The 2nd Department Of Internal Medicine Toyama Medical And Pharmaceutical University

• Hirai Tadakazu

  The 2nd Department Of Internal Medicine Toyama Medical And Pharmaceutical University

• Miwa Kunihisa

  Fukuda General Hospital

• Kinugawa Toru

  Kinugawa Cardiology Clinic

• Takeishi Yasuchika

  Yamagata University School Of Medicine

• Hirai Tadakazu

  University of Toyama

• Senda Shoichi

  Kagawa Medical University

• Hiraoka Yuji

  Rakuwakai Otowa Hospital

• Hosokawa Ryohei

  Kitano Hospital

• Fujita Masatoshi

  Department Of Human Health Sciences Graduate School Of Medicine Kyoto University

• TAKADA YASUHARU

  Saijo Central Hospital

• Furudate Masayori

  Hokkaido Cardiac Metabolism Imaging Study Group

• Takahashi Yojiro

  Division Of Cardiovascular Medicine Department Of Medical Bioregulation Yamaguchi University School

• Fujita Masatoshi

  The 2nd Department Of Internal Medicine Toyama Medical & Pharmaceutical University

• Yamamoto Takeshi

  Division Of Cardiovascular Medicine Department Of Medical Bioregulation Yamaguchi University School

• Yamamoto Takeshi

  Division Of Cardiology Tokuyama Central Hospital

• Mizumaki Kohichi

  The Second Department Of Internal Medicine Toyama Medical And Phamaceutical University

• Mizumaki Kouichi

  Second Department Of Internal Medicine Faculty Of Medicine Toyama Medical And Pharmaceutical University

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