Response to mental and physical stress before and during adrenoreceptor blocker and angiotensin-converting enzyme inhibitor treatment in essential hypertension.
The effects of mental, static and dynamic stresses on physiologic parameters before and after beta-blocker (n = 24) and angiotensin-converting enzyme inhibitor (n = 29) treatment were examined. Mental stress induced similar elevation in systolic and diastolic blood pressures (BPs) with and without beta-blocker treatment. During angiotensin-converting enzyme inhibitor treatment, the change in systolic BP was significantly greater (p less than 0.05). Heart rate response was attenuated by beta blockers and unchanged by the angiotensin-converting enzyme inhibitor. Skin temperature and galvanic skin resistance significantly decreased (p less than 0.05) with mental stress. Beta blockers did not change the response pattern, whereas the angiotensin-converting enzyme inhibitor attenuated the stress-induced reduction of both skin temperature and galvanic skin response. After handgrip exercise, increases in systolic and diastolic BPs and heart rate were similar before and after beta-blocker treatment, whereas the angiotensin-converting enzyme inhibitor induced small but significantly fewer (p less than 0.05) changes in diastolic BP and heart rate. Treadmill exercise induced similar changes in systolic and diastolic BPs with both treatments compared with no treatment. The angiotensin-converting enzyme inhibitor appears to provide additional protection to that seen with beta blockers during mental and static stressors by blunted changes in skin temperature and galvanic skin resistance.
Coronary Care Service, Soroka University Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
E
E
Paran
L
L
Neumann
N
N
Cristal
D T
DT
Lowenthal
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D004656:Enalapril / Q000627:therapeutic use; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013315:Stress, Psychological / Q000503:physiopathology*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril