Effect of Evening Bromazepam Administration on Blood Pressure and Heart Rate in Mild Hypertensive Patients

Alfredo Costa, Daniele Bosone, Matteo Cotta Ramusino, Giulia Perini, Natascia Ghiotto, Annalisa Zoppi, Angela D Apos Angelo, Roberto Fogari

Research output: Contribution to journalArticle

Abstract

AIM: To assess the effects of chronic evening oral administration of bromazepam alone or in combination with propranolol on ambulatory blood pressure (BP) and heart rate (HR) in mild hypertensive subjects.

METHODS: Thirty-seven mild hypertensive patients after a 2-week placebo period were randomized to bromazepam 3 mg, propranolol 40 mg, bromazepam 3 mg plus propranolol 40 mg or placebo for 2 weeks according to a double-blind, double dummy, cross-over design. After each treatment period, 24-h BP and HR ambulatory monitoring was performed by using a non-invasive device.

RESULTS: Ambulatory monitoring showed that during night-time SBP and DBP values were unaffected by bromazepam as compared to placebo, whereas SBP was significantly reduced by propranolol both when taken alone and in combination with bromazepam. HR nocturnal values were significantly reduced by propranolol, whereas they were significantly increased by bromazepan both when taken alone (+11.5%, p < 0.05 vs. placebo) and in combination with propranolol (+12.8%, p < 0.05 vs. propranolol). No significant difference in day-time values of SBP, DBP and HR was observed among the 4 treatment groups.

CONCLUSIONS: In mild hypertensive patients, evening consumption of bromazepam for a 2-week period did not affect BP, while it increased nocturnal HR. Such an increase was observed both when bromazepam was taken alone and in combination with propranolol, which suggests that it depends on a bromazepam mediated decrease in vagal tone. Whatever the mechanism, the HR nocturnal increase might be of clinical relevance, due to the role of high HR as cardiovascular risk factor, particularly in already at risk hypertensive subjects.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalPharmacology
Volume104
Issue number1-2
DOIs
Publication statusPublished - Apr 3 2019

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Bromazepam
Propranolol
Heart Rate
Blood Pressure
Placebos
Ambulatory Monitoring
Cross-Over Studies
Oral Administration
Equipment and Supplies

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Effect of Evening Bromazepam Administration on Blood Pressure and Heart Rate in Mild Hypertensive Patients. / Costa, Alfredo; Bosone, Daniele; Cotta Ramusino, Matteo; Perini, Giulia; Ghiotto, Natascia; Zoppi, Annalisa; D Apos Angelo, Angela; Fogari, Roberto.

In: Pharmacology, Vol. 104, No. 1-2, 03.04.2019, p. 1-6.

Research output: Contribution to journalArticle

Costa, Alfredo ; Bosone, Daniele ; Cotta Ramusino, Matteo ; Perini, Giulia ; Ghiotto, Natascia ; Zoppi, Annalisa ; D Apos Angelo, Angela ; Fogari, Roberto. / Effect of Evening Bromazepam Administration on Blood Pressure and Heart Rate in Mild Hypertensive Patients. In: Pharmacology. 2019 ; Vol. 104, No. 1-2. pp. 1-6.
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abstract = "AIM: To assess the effects of chronic evening oral administration of bromazepam alone or in combination with propranolol on ambulatory blood pressure (BP) and heart rate (HR) in mild hypertensive subjects.METHODS: Thirty-seven mild hypertensive patients after a 2-week placebo period were randomized to bromazepam 3 mg, propranolol 40 mg, bromazepam 3 mg plus propranolol 40 mg or placebo for 2 weeks according to a double-blind, double dummy, cross-over design. After each treatment period, 24-h BP and HR ambulatory monitoring was performed by using a non-invasive device.RESULTS: Ambulatory monitoring showed that during night-time SBP and DBP values were unaffected by bromazepam as compared to placebo, whereas SBP was significantly reduced by propranolol both when taken alone and in combination with bromazepam. HR nocturnal values were significantly reduced by propranolol, whereas they were significantly increased by bromazepan both when taken alone (+11.5{\%}, p < 0.05 vs. placebo) and in combination with propranolol (+12.8{\%}, p < 0.05 vs. propranolol). No significant difference in day-time values of SBP, DBP and HR was observed among the 4 treatment groups.CONCLUSIONS: In mild hypertensive patients, evening consumption of bromazepam for a 2-week period did not affect BP, while it increased nocturnal HR. Such an increase was observed both when bromazepam was taken alone and in combination with propranolol, which suggests that it depends on a bromazepam mediated decrease in vagal tone. Whatever the mechanism, the HR nocturnal increase might be of clinical relevance, due to the role of high HR as cardiovascular risk factor, particularly in already at risk hypertensive subjects.",
author = "Alfredo Costa and Daniele Bosone and {Cotta Ramusino}, Matteo and Giulia Perini and Natascia Ghiotto and Annalisa Zoppi and {D Apos Angelo}, Angela and Roberto Fogari",
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T1 - Effect of Evening Bromazepam Administration on Blood Pressure and Heart Rate in Mild Hypertensive Patients

AU - Costa, Alfredo

AU - Bosone, Daniele

AU - Cotta Ramusino, Matteo

AU - Perini, Giulia

AU - Ghiotto, Natascia

AU - Zoppi, Annalisa

AU - D Apos Angelo, Angela

AU - Fogari, Roberto

N1 - © 2019 S. Karger AG, Basel.

PY - 2019/4/3

Y1 - 2019/4/3

N2 - AIM: To assess the effects of chronic evening oral administration of bromazepam alone or in combination with propranolol on ambulatory blood pressure (BP) and heart rate (HR) in mild hypertensive subjects.METHODS: Thirty-seven mild hypertensive patients after a 2-week placebo period were randomized to bromazepam 3 mg, propranolol 40 mg, bromazepam 3 mg plus propranolol 40 mg or placebo for 2 weeks according to a double-blind, double dummy, cross-over design. After each treatment period, 24-h BP and HR ambulatory monitoring was performed by using a non-invasive device.RESULTS: Ambulatory monitoring showed that during night-time SBP and DBP values were unaffected by bromazepam as compared to placebo, whereas SBP was significantly reduced by propranolol both when taken alone and in combination with bromazepam. HR nocturnal values were significantly reduced by propranolol, whereas they were significantly increased by bromazepan both when taken alone (+11.5%, p < 0.05 vs. placebo) and in combination with propranolol (+12.8%, p < 0.05 vs. propranolol). No significant difference in day-time values of SBP, DBP and HR was observed among the 4 treatment groups.CONCLUSIONS: In mild hypertensive patients, evening consumption of bromazepam for a 2-week period did not affect BP, while it increased nocturnal HR. Such an increase was observed both when bromazepam was taken alone and in combination with propranolol, which suggests that it depends on a bromazepam mediated decrease in vagal tone. Whatever the mechanism, the HR nocturnal increase might be of clinical relevance, due to the role of high HR as cardiovascular risk factor, particularly in already at risk hypertensive subjects.

AB - AIM: To assess the effects of chronic evening oral administration of bromazepam alone or in combination with propranolol on ambulatory blood pressure (BP) and heart rate (HR) in mild hypertensive subjects.METHODS: Thirty-seven mild hypertensive patients after a 2-week placebo period were randomized to bromazepam 3 mg, propranolol 40 mg, bromazepam 3 mg plus propranolol 40 mg or placebo for 2 weeks according to a double-blind, double dummy, cross-over design. After each treatment period, 24-h BP and HR ambulatory monitoring was performed by using a non-invasive device.RESULTS: Ambulatory monitoring showed that during night-time SBP and DBP values were unaffected by bromazepam as compared to placebo, whereas SBP was significantly reduced by propranolol both when taken alone and in combination with bromazepam. HR nocturnal values were significantly reduced by propranolol, whereas they were significantly increased by bromazepan both when taken alone (+11.5%, p < 0.05 vs. placebo) and in combination with propranolol (+12.8%, p < 0.05 vs. propranolol). No significant difference in day-time values of SBP, DBP and HR was observed among the 4 treatment groups.CONCLUSIONS: In mild hypertensive patients, evening consumption of bromazepam for a 2-week period did not affect BP, while it increased nocturnal HR. Such an increase was observed both when bromazepam was taken alone and in combination with propranolol, which suggests that it depends on a bromazepam mediated decrease in vagal tone. Whatever the mechanism, the HR nocturnal increase might be of clinical relevance, due to the role of high HR as cardiovascular risk factor, particularly in already at risk hypertensive subjects.

U2 - 10.1159/000499371

DO - 10.1159/000499371

M3 - Article

C2 - 30943497

VL - 104

SP - 1

EP - 6

JO - Pharmacology

JF - Pharmacology

SN - 0031-7012

IS - 1-2

ER -