Effects of long-acting propranolol and verapamil on blood pressure, platelet function, metabolic and rheological properties in hypertension.
The newly developed antihypertensive drugs, the long-acting beta-blocker propranolol and the sustained release calcium antagonist verapamil, are compared in their antihypertensive, platelet function, rheological properties and metabolic effects. The trial was a double-blind, randomised, placebo-controlled cross-over study. Thirty patients with mild to moderate hypertension received propranolol (40-120 mg) or verapamil (80-200 mg) once daily in two separate ten week courses. After ten weeks treatment both drugs had significantly reduced both SBP and DBP. Beta-thromboglobulin (beta-TG) concentration, reflecting the status of platelet activation in vivo, was significantly decreased after propranolol (129.6 +/- 13.5 vs. 77.9 +/- 8.6 ng/ml) and verapamil (129.6 +/- 13.5 vs. 90.7 +/- 10.1 ng/ml) treatments while platelet aggregation induced by ADP, collagen, arachidonic acid or adrenaline and the production of thromboxane B2 (TXB2), 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) and platelet cyclic 3'-5' adenosine monophosphate (C-AMP) concentration were not affected. Significant alterations in rheological parameters such as plasma and whole blood viscosity, fibrinogen level and red cell deformability were not found. Higher cholesterol and low-density lipoprotein-cholesterol (LDL-C) levels were observed after propranolol treatment but not in verapamil treatment. Side-effects were mild, tolerated and no patient had to be withdrawn from the study. In conclusion, propranolol and verapamil are generally effective antihypertensive as well as rheologically safe drugs. Compared with the metabolic effect on serum lipid, verapamil may be a better choice. Both drugs possess the tendency to inhibit platelet properties which is desirable in hypertension treatment.
Department of Medicine, Tri-Service General Hospital, National Defense Medical Centre, Taipei, Taiwan, Republic of China.
Y A
YA
Ding
T C
TC
Chou
K C
KC
Lin
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D001792:Blood Platelets / Q000187:drug effects / Q000502:physiology*; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004907:Erythrocyte Deformability; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects / Q000502:physiology; D010978:Platelet Factor 4 / Q000032:analysis; D011433:Propranolol / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D013929:Thromboxane B2 / Q000097:blood; D013997:Time Factors; D014700:Verapamil / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D001620:beta-Thromboglobulin / Q000032:analysis
D001620:beta-Thromboglobulin; D010978:Platelet Factor 4; D013929:Thromboxane B2; D011433:Propranolol; D014700:Verapamil