Postprandial Hemodynamic Changes in Hypertensives Treated with Calcium Antagonists or ACE Inhibitors.
Our aim was to investigate possible abnormalities in postprandial hemodynamic changes in hypertensives treated with different vasodilating drugs, calcium antagonists, or angiotensin-converting enzyme inhibitors. Eleven healthy subjects and 22 hypertensive patients effectively treated with an angio tensin-converting enzyme inhibitor (ACEI) (n = 9) or calcium antagonists (n = 13) were studied. Cardiac output and blood pressure were monitored every 20 min from 2 h before lunch to 3 h after using a computer-assisted impedance cardiograph coupled with an automatic blood pressure monitor. After meals, a significant decrease in mean arterial pressure (minus sign7.9% plus minus 2.1) was observed in ACEI-treated hypertensives when compared with the minor changes observed in calcium-antagonist-treated hypertensives (minus sign3.7% plus minus 1.5) and in normotensives (minus sign2.7% plus minus 1.5). When compared with normotensives, the patients treated with ACEI showed a larger postprandial fall in total peripheral resistance index (minus sign20.8% plus minus 3.4 versus minus sign15.3% plus minus 4.1) with a larger increase in heart rate (11.3% plus minus 2.3 versus 8.1% plus minus 1.3). In hypertensives treated with calcium antagonists, the postprandial hemodynamic changes appeared blunted and not significant. Different antihypertensive drugs appear to have different effects on the postprandial hemodynamic changes.
Musumice
V.
V
Cattedra di Medicina Interna, CLOPD.
Di Salvo
S.
S
Campia
U.
U
Cardillo
C.
C