:Cardiac Output/Cardiopulmonary Blood Volume in Essential Hypertension

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Haemodynamic studies (using radiocardiography) were carried out in outpatients with essential hypertension, namely in 12 cases (av. 52 yrs) taking metolazone, in 15 patients (av. 41 yrs) taking trichlormethiazide and in 5 patients (av. 50 yrs) taking mefruside. After short-term (av. 6.7 wks) metolazone therapy, there were a significant decrease in mean blood pressure (MBP) (from 129±4 mmHg to 108 ±3mmHg, P<0.005), and a significant reduction in cardiac output (CI) (from 3.79±0.20 1/mm/m2 to 3.33±0.24 1/min/m2, P<0.05) without any change in total peripheral resistance index (TPRI). Short-term (av. 7.9 wks) trichlormethiazide treatement and short-term (av. 4.8 wks) mefruside treatment reduced MBP (trichlormethiazide, from 124±4 mmHg to 111±3 mmHg, P<0.005 ; mefruside, from 119±7 mmHg to 110±4 mmHg, ns). Both of these drugs induced similar haemodynamic changes to those observed with metolazone ; CI fell from 4.21±0.29 1/min/m2 to 3.99±0.32 1/min/m2 in the trichlormethiazide-treated group, and fell from 3.95±0.39 1/min/m2 to 3.56±0.25 1/min/m2 in the mefruside-treated group, however, these changes were not significant. In the long-term (av. 28.5 wks) metolazone therapy MBP fell from 130±4 to 101±3 mmHg (P<0.005), and CI fell from 3.74±0.22 1/min/m2 to 3.23±0.21 1/min/m2 (P<0.05) as observed in the short-term metolazone therapy, while TPRI tended to decrease from 2, 858±197 dyne·sec·cm-5·m2 to 2, 573±158 dyne·sec·cm-5Em2 (ns). Reduced cardiac output in the short-term metolazone therapy can be postulated to be due to reduced ECF and reauced venous return. However, many observations in the thiazide therapy indicate that cardiac output tended to return to the pretreatment values during continued treatment. A possible mechanism of reduced CI in the long-term metolazone therapy may be partially attributed to a decrease in cardiopulmonary blood volume (CPBV), which may reflect venous return to the heart. Another mechansim seemed to be partially due to a decrease in CI/CPBV, while the decreases in the short- and long-term metolazone therapy were not so much those in the intravenous propranolol (0.4 mg/kg) and in the oral propranolol therapy.
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:Cardiac Output/Cardiopulmonary Blood Volume in Essential Hypertension

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