title: Cardiovascular adaptation to mudpack therapy in hypertensive subjects treated with different antihypertensive drugs.
abstract: OBJECTIVE
  In selected hypertensive subjects, cardiovascular adaptation to warm environments may be inadequate or even harmful: heating associated to mudpack therapy may cause unexpected hypotension. How different antihypertensive drugs may affect the cardiovascular response to mudpack therapy is poorly studied.
  
  
  OBJECTIVE
  To evaluate the effects of β-blockers and angiotensin II receptor antagonists/ACE inhibitors on the acute cardiovascular adaptation to mudpack treatment in SPA in elderly hypertensive patients.
  
  
  METHODS
  Thirty-one elderly subjects were divided in normotensive subjects (N; n=10) and hypertensive patients treated with ACE-inhibitors/Angiotensin II receptor antagonists (HTA; n=12) or with selective β1-blockers (HTB; n=9). Systolic (SBP) and diastolic (DBP) blood pressure were continuously recorded (10 min) in supine position, immediately before and during mudpack treatment (40°C). Heart rate (HR), stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were assessed.
  
  
  RESULTS
  During mudpack treatment SBP did not significantly change in both HTA and N groups (132±11 and 112±13 mmHg, respectively), but significantly decreased in HTB (111±18 mmHg, p < 0.01 vs baseline) patients. HR increased in all groups (HTA: 72±10 bpm; HTB: 65±6 bpm; N: 70±10 bpm; p < 0.01 vs baseline). A significant reduction (p < 0.01 vs baseline) in SV and CO occurred in HTB, but not in HTA and N groups. TPR significantly increased in HTB (1335±464 dyn.s.cm-5, p < 0.01 vs baseline) but not in HTA and N subjects (1389±385 dyn.s.cm-5 and 1245±323 dyn.s.cm-5, respectively).
  
  
  CONCLUSIONS
  Mud treatment did not cause relevant haemodynamic changes in normotensive and HTA-treated hypertensive subjects. Conversely, β-blocking treatment apparently limited the cardiovascular adaptation to thermic stress, through a possible reduction in myocardial contractility, thereby, causing a significant decrease, although not dangerous, in systolic blood pressure.
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. giampiero.merati@unimi.it.
authors.forename: G
authors.initials: G
authors.lastname: Merati
authors.forename: L
authors.initials: L
authors.lastname: Agnello
authors.forename: S
authors.initials: S
authors.lastname: Rampichini
authors.forename: M A
authors.initials: MA
authors.lastname: Maggioni
authors.forename: R
authors.initials: R
authors.lastname: Scurati
authors.forename: A
authors.initials: A
authors.lastname: Veicsteinas
mesh_terms: D000222:Adaptation, Physiological / Q000187:drug effects; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects / Q000503:physiopathology; D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000009:adverse effects / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods*; D008297:Male; D014655:Vascular Resistance
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents