title: Reactivity to mental stress and cold provocation during long-term treatment with metoprolol, propranolol or hydrochlorothiazide.
abstract: In a study aimed at comparing the effects of beta-blockers and thiazide diuretics on responses to stressful provocations, 45 essential hypertensives (WHO I-II) were treated with either the selective beta-blocker metoprolol (METO), the non-selective beta-blocker propranolol (PROP) or hydrochlorothiazide (HTZ) for 6 months. Blood pressure, heart rate and plasma catecholamines were measured in connection with a mental stress test and a cold pressor test before and during therapy. All drugs reduced outpatient blood pressure similarly, but beta-blockade reduced blood pressure and heart rate levels more efficiently at rest and during stress in the laboratory. Heart rate reactivity to stress was reduced mostly by beta-blockade during mental stress. Blood pressure and sympatho-adrenal reactivity were unchanged by therapy. Stress reactivity failed to predict antihypertensive responses. The results suggest that beta-blockade may be more effective than diuretic treatment in reducing blood pressure levels and cardiac workload as assessed by the rate pressure product in stressful situations.
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000097:blood; D003080:Cold Temperature; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use*; D011581:Psychological Tests; D013315:Stress, Psychological / Q000503:physiopathology*; D013997:Time Factors
chemical_list: D002395:Catecholamines; D006852:Hydrochlorothiazide; D011433:Propranolol; D008790:Metoprolol