Cardiovascular adaptation to mudpack therapy in hypertensive subjects treated with different antihypertensive drugs

G. Merati, L. Agnello, S. Rampichini, M. A. Maggioni, R. Scurati, A. Veicsteinas

Research output: Contribution to journalArticlepeer-review


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. AIMS: 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. PATIENTS AND 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 normoten-sive and HTA-treated hypertensive subjects. Conversely, β-blocking treatment apparently limited the cardiovascular adaptation to thermic stress, through a possible reduction in myocar-dial contractility, thereby, causing a significant decrease, although not dangerous, in systolic blood pressure.

Original languageEnglish
Pages (from-to)2544-2550
Number of pages7
JournalEuropean Review for Medical and Pharmacological Sciences
Issue number17
Publication statusPublished - 2014


  • ACE-inhibitors
  • Angiotensin II receptor antagonists
  • SPA therapy
  • β-blockers

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)


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