No cardiovascular effects of single-dose pseudoephedrine in patients with essential hypertension treated with beta-blockers.
OBJECTIVE
The use of the decongestant pseudoephedrine has been cautioned in patients with arterial hypertension, due to the possible rise in blood pressure induced by the sympathostimulatory properties of the drug. This effect could be enhanced in hypertensives treated with beta-blockers, in whom the vasoconstrictor effect of alpha-adrenergic stimulation is unbalanced. The purpose of this study was to investigate the cardiovascular response to pseudoephedrine in hypertensive patients treated with different types of beta-blockers.


METHODS
We recruited 29 (18 males) mild-to-moderate essential hypertensive patients [mean age 49(2) years] in a randomized, placebo-controlled, crossover trial. All participants received either placebo, or a nonselective (propranolol 160 mg once daily) or a selective (atenolol 100 mg once daily) beta-blocker for 1 week. At the end of each period, all patients received a single oral dose of pseudoephedrine (60 mg) and their blood pressure and heart rate were monitored at repeated intervals for 2 h.


RESULTS
After 1 week of propranolol or atenolol, patients had significantly lower systolic blood pressure and heart rate than after placebo, whereas diastolic blood pressure was not significantly modified. The acute administration of pseudoephedrine did not change systolic and diastolic blood pressure and heart rate from baseline at the end of any of the treatment periods.


CONCLUSIONS
A standard oral dose of pseudoephedrine does not significantly affect blood pressure values in hypertensive patients treated with beta-blockers, and therefore may be safely used in this subset of patients.
Mores
N
N
Istituto di Farmacologia, Università Cattolica del Sacro Cuore, Rome, Italy. nmores@yahoo.com
Campia
U
U
Navarra
P
P
Cardillo
C
C
Preziosi
P
P
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D004809:Ephedrine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D014662:Vasoconstrictor Agents / Q000009:adverse effects* / Q000627:therapeutic use
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D014662:Vasoconstrictor Agents; D004809:Ephedrine