Evidence of increased sympathetic vasomotor drive with shorter acting dihydropyridine calcium channel antagonists in human hypertension

A study using spectral analysis of RR interval and systolic arterial pressure variability

Daniela Lucini, Giuseppe Sandro Mela, Alberto Malliani, Massimo Pagani

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

We studied the effects of common antihypertensive regimens on autonomic cardiovascular control. We considered calcium channel antagonists (nicardipine twice a day and isradipine once a day, respectively) and also examined, as reference treatments, once-a-day atenolol and cilazapril. A noninvasive evaluation of autonomic cardiovascular profile was obtained with spectral analysis of RR interval and systolic arterial pressure variability. We studied moderate essential hypertensives before and after 2 weeks of treatment, both at rest and during active standing and mental arithmetic. All treatments reduced arterial pressure equally well; however, marked differences in spectral profiles were observed. The low-frequency spectral component of RR interval variability tin normalized units, marker of sympathetic modulation of the sinoatrial (SA) node] tended to be greater at rest and during stimuli (p <0.001) in subjects treated with dihydropyridines. No differences at rest, but striking increases of the low- frequency component of systolic arterial pressure variability were observed in nicardipine-treated patients during both standardized excitatory stimuli, suggesting a marked increase in sympathetic vasomotor drive. As to reference treatments, patients treated with atenolol displayed the lowest values, and patients treated with cilazapril (for 4 weeks) provided intermediate values. In conclusion, shorter acting dihydropyridine calcium channel antagonists may induce an exaggerated in crease in sympathetic vasomotor drive during standardized laboratory stressors.

Original languageEnglish
Pages (from-to)676-683
Number of pages8
JournalJournal of Cardiovascular Pharmacology
Volume29
Issue number5
DOIs
Publication statusPublished - May 1997

Fingerprint

Calcium Channel Blockers
Arterial Pressure
Cilazapril
Blood Pressure
Hypertension
Nicardipine
Atenolol
Isradipine
Dihydropyridines
Sinoatrial Node
Tin
Therapeutics
Antihypertensive Agents
1,4-dihydropyridine

Keywords

  • β-Adrenergic receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Calcium channel antagonists
  • Cardiovascular risk
  • Sympathetic activity

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Evidence of increased sympathetic vasomotor drive with shorter acting dihydropyridine calcium channel antagonists in human hypertension: A study using spectral analysis of RR interval and systolic arterial pressure variability",
abstract = "We studied the effects of common antihypertensive regimens on autonomic cardiovascular control. We considered calcium channel antagonists (nicardipine twice a day and isradipine once a day, respectively) and also examined, as reference treatments, once-a-day atenolol and cilazapril. A noninvasive evaluation of autonomic cardiovascular profile was obtained with spectral analysis of RR interval and systolic arterial pressure variability. We studied moderate essential hypertensives before and after 2 weeks of treatment, both at rest and during active standing and mental arithmetic. All treatments reduced arterial pressure equally well; however, marked differences in spectral profiles were observed. The low-frequency spectral component of RR interval variability tin normalized units, marker of sympathetic modulation of the sinoatrial (SA) node] tended to be greater at rest and during stimuli (p <0.001) in subjects treated with dihydropyridines. No differences at rest, but striking increases of the low- frequency component of systolic arterial pressure variability were observed in nicardipine-treated patients during both standardized excitatory stimuli, suggesting a marked increase in sympathetic vasomotor drive. As to reference treatments, patients treated with atenolol displayed the lowest values, and patients treated with cilazapril (for 4 weeks) provided intermediate values. In conclusion, shorter acting dihydropyridine calcium channel antagonists may induce an exaggerated in crease in sympathetic vasomotor drive during standardized laboratory stressors.",
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author = "Daniela Lucini and Mela, {Giuseppe Sandro} and Alberto Malliani and Massimo Pagani",
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AU - Lucini, Daniela

AU - Mela, Giuseppe Sandro

AU - Malliani, Alberto

AU - Pagani, Massimo

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N2 - We studied the effects of common antihypertensive regimens on autonomic cardiovascular control. We considered calcium channel antagonists (nicardipine twice a day and isradipine once a day, respectively) and also examined, as reference treatments, once-a-day atenolol and cilazapril. A noninvasive evaluation of autonomic cardiovascular profile was obtained with spectral analysis of RR interval and systolic arterial pressure variability. We studied moderate essential hypertensives before and after 2 weeks of treatment, both at rest and during active standing and mental arithmetic. All treatments reduced arterial pressure equally well; however, marked differences in spectral profiles were observed. The low-frequency spectral component of RR interval variability tin normalized units, marker of sympathetic modulation of the sinoatrial (SA) node] tended to be greater at rest and during stimuli (p <0.001) in subjects treated with dihydropyridines. No differences at rest, but striking increases of the low- frequency component of systolic arterial pressure variability were observed in nicardipine-treated patients during both standardized excitatory stimuli, suggesting a marked increase in sympathetic vasomotor drive. As to reference treatments, patients treated with atenolol displayed the lowest values, and patients treated with cilazapril (for 4 weeks) provided intermediate values. In conclusion, shorter acting dihydropyridine calcium channel antagonists may induce an exaggerated in crease in sympathetic vasomotor drive during standardized laboratory stressors.

AB - We studied the effects of common antihypertensive regimens on autonomic cardiovascular control. We considered calcium channel antagonists (nicardipine twice a day and isradipine once a day, respectively) and also examined, as reference treatments, once-a-day atenolol and cilazapril. A noninvasive evaluation of autonomic cardiovascular profile was obtained with spectral analysis of RR interval and systolic arterial pressure variability. We studied moderate essential hypertensives before and after 2 weeks of treatment, both at rest and during active standing and mental arithmetic. All treatments reduced arterial pressure equally well; however, marked differences in spectral profiles were observed. The low-frequency spectral component of RR interval variability tin normalized units, marker of sympathetic modulation of the sinoatrial (SA) node] tended to be greater at rest and during stimuli (p <0.001) in subjects treated with dihydropyridines. No differences at rest, but striking increases of the low- frequency component of systolic arterial pressure variability were observed in nicardipine-treated patients during both standardized excitatory stimuli, suggesting a marked increase in sympathetic vasomotor drive. As to reference treatments, patients treated with atenolol displayed the lowest values, and patients treated with cilazapril (for 4 weeks) provided intermediate values. In conclusion, shorter acting dihydropyridine calcium channel antagonists may induce an exaggerated in crease in sympathetic vasomotor drive during standardized laboratory stressors.

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