Effect of digoxin on circadian blood pressure values in patients with congestive heart failure.
BACKGROUND
The aim of the study was to investigate the effect of chronic digoxin treatment on circadian blood pressure profile in normotensive patients with mild congestive heart failure.


METHODS
In a randomized double-blind, placebo-controlled cross-over protocol, 12 normotensive patients with mild congestive heart failure took digoxin or placebo for a total of 7 days. Automatic 24-h ambulatory blood pressure measurements were carried out at day 7, of either digoxin or placebo.


RESULTS
Diastolic blood pressure significantly decreased and systolic blood pressure significantly increased during overnight sleep in the digoxin phase compared to placebo. Digoxin had no effect on either systolic or diastolic blood pressure during daytime. Heart rate decreased in the overnight sleeping phase but did not differ significantly between placebo and digoxin phase.


CONCLUSIONS
Digoxin significantly decreases diastolic blood pressure during overnight sleep in patients with congestive heart failure. This effect is likely to be caused by reduction of sympathetic activity or increase of parasympathetic activity. Increase of systolic blood pressure during sleep is probably caused by the positive inotropic effect of the drug.
Kirch
C
C
Faculty of Medicine, University of Technology, Dresden, Germany.
Grossmann
M
M
Fischer
S
S
Neumeister
V
V
Kirch
W
W
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002940:Circadian Rhythm / Q000502:physiology*; D003971:Diastole / Q000187:drug effects; D004077:Digoxin / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D013599:Systole / Q000187:drug effects
D002316:Cardiotonic Agents; D010919:Placebos; D004077:Digoxin