Hemodynamic profiles of antihypertensive agents.
Alpha-blockers tend to normalize central hemodynamics and only modestly reduce the systolic blood pressure-heart rate (SBP x HR) product. Similarly, dihydropyridine calcium antagonists normalize central hemodynamics, but at the expense of an increased heart rate (which tends to normalize chronic treatment). Non-dihydropyridine calcium antagonists tend to reduce resting heart rate. Angiotensin converting enzyme (ACE) inhibitors normalize central hemodynamics with no change in heart rate. Classic beta-blockers, particularly the non-selective agents, lower heart rate and cardiac output at rest and during exercise, with a reflex increase in total peripheral resistance (TPR), which lessens with chronic therapy. With dual-acting beta-blockers like carvedilol, the fall in blood pressure is accompanied by a fall in TPR and only a modest drop in cardiac output; the increase in AVO2 difference is less marked with carvedilol compared to a classic beta-blocker, suggesting that the body's reserve mechanisms may be less reduced.
Lund-Johansen
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Medical Department, University of Bergen School of Medicine, Haukeland Hospital, Norway.
D000959:Antihypertensive Agents / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans
D000959:Antihypertensive Agents