Comparative effects of rilmenidine and atenolol on tests of autonomic function and mental and dynamic exercise in patients with essential hypertension.
The aim of the present study was to compare the effects of rilmenidine (1-2 mg/day) and atenolol (50-100 mg/day) on tests of mental arithmetic, bicycle exercise, and autonomic function. Twelve male patients with mild-to-moderate hypertension (blood pressure, 160/95 +/- 15/7 mm Hg; age range, 32 to 60 years) completed a randomized, double-blind, crossover study. Both drugs were well tolerated and, after 4 weeks of monotherapy, were associated with significant reductions in supine and erect BP. Hemodynamic responses to mental arithmetic were similar for both drugs, and neither agent affected mental performance as judged by psychomotor testing. The increase in heart rate during bicycle exercise was significantly greater with rilmenidine (50 vs. 41 beats/min, p = 0.04), and during the postexercise recovery phase, areas under the curve for diastolic blood pressure and heart rate were smaller after atenolol than after rilmenidine: 46,450 versus 51,400 mm Hg.s (p = 0.02) and 49,445 versus 63,597 beats/min.s (p = 0.001), respectively. In conclusion, rilmenidine and atenolol exert comparable antihypertensive effects both at rest and during mental and dynamic exercise. Although atenolol blunted the heart rate responses to dynamic exercise and the Valsalva maneuver, rilmenidine showed no interference with physiological hemodynamic responses of blood pressure and heart rate during tests of sympathetic and parasympathetic function.
Panfilov
V
V
Department of Medicine and Therapeutics, University of Glasgow, Scotland.
Morris
A D
AD
Donnelly
R
R
Reid
J L
JL
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001262:Atenolol / Q000009:adverse effects / Q000627:therapeutic use*; D001341:Autonomic Nervous System / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005080:Exercise Test / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008606:Mental Processes / Q000187:drug effects*; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000187:drug effects / Q000502:physiology; D010080:Oxazoles / Q000009:adverse effects / Q000627:therapeutic use*; D000077769:Rilmenidine
D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D010080:Oxazoles; D001262:Atenolol; D000077769:Rilmenidine