[Acute hemodynamic effects of prostacyclin in severe or malignant hypertension].
The antihypertensive effect of Prostacyclin (PGI2) was investigated in 7 patients with severe or malignant hypertension. Cardiac output (dilution method), arterial blood pressure and total blood volume (TBV, radio-albumin dilution method) were measured before and during a PGI2 infusion, the effective dose ranging from 10 to 20 ng/kg/min. Cardiac index(CI) rose from 2.8 to 3.9 1/min/m2 and heart rate (HR) from 75 to 94 beats/min (p less than 0.01) Mean blood pressure decreased from 154 to 120 mmHg (p less than 0.001) and total peripheral resistances from 4650 to 2540 dynes.s.cm-5 (p less than 0.001). The ratio: central blood volume/total blood volume increased from 0.21 to 0.26 (p less than 0.001). The results confirm that PGI2 produces a potent vasodilatation of the systemic compartment with a marked decrease in blood pressure; however the antihypertensive effect is blunted by the increase in CI mainly related to the increase in HR; significant central translocation of blood suggests that PGI2 does not produce dilatation of the capacitance vessels. Sympathetic nervous system is highly stimulated by PGI2 very likely through the baroreceptor system.
D000959:Antihypertensive Agents / Q000008:administration & dosage; D001810:Blood Volume / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D011464:Epoprostenol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D006974:Hypertension, Malignant / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011453:Prostaglandins / Q000627:therapeutic use*; D014655:Vascular Resistance / Q000187:drug effects
D000959:Antihypertensive Agents; D011453:Prostaglandins; D011464:Epoprostenol
Effets hémodynamiques aigus de la prostacycline dans les hypertensions sévères ou malignes.