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The selective alpha 2 ‐adrenergic receptor agonist dexmedetomidine (DEX) does not affect aortic pressure augmentation
Author(s) -
Kurnik D.,
Sofowora G. G.,
Muszkat M.,
Harris P.A.,
Wood A. J.,
Stein C. M.
Publication year - 2005
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2004.11.046
Subject(s) - blood pressure , medicine , pulse pressure , heart rate , aortic pressure , radial artery , arterial stiffness , cardiology , anesthesia , placebo , artery , alternative medicine , pathology
Background Despite a similar reduction in peripheral blood pressure (BP), antihypertensive drugs have variable effects on central blood pressure and its augmentation by the reflected pulse wave, a measure of arterial stiffness. Infusion of norepinephrine (NE) increases arterial stiffness. Centrally acting alpha 2 ‐AR agonists decrease NE concentrations and blood pressure, but their effects on aortic pressure augmentation are not known. Methods In a single‐blind, placebo‐controlled study, 36 healthy subjects received sequential infusions of placebo and DEX (0.1, 0.15 and 0.15 mcg/kg). Brachial artery blood pressure, heart rate, and NE plasma concentrations were measured at baseline and after every infusion. Radial artery waveforms were recorded by applanation tonometry (Sphygmocor) and the central aortic waveform and augmentation index ‐ the proportional increase in systolic pressure due to the reflected wave ‐ calculated. Results DEX reduced brachial and central systolic (−15.0±6.2 (SD) and −12.6±5.8 mmHg) and diastolic BP (−9.9±6.5 and −10.1±6.6 mmHg), respectively (p<0.001). NE levels decreased (−103±68 pg/mL, p<0.001) but augmentation index did not change (placebo 3.4±10.3% vs DEX 3.0±10.1%, P=0.8). Conclusion DEX reduced NE concentrations and central and peripheral blood pressure but did not alter aortic pressure augmentation. Pharmacological reduction of endogenous baseline NE concentrations did not alter arterial stiffness and pulse wave reflection. Clinical Pharmacology & Therapeutics (2005) 77 , P11–P11; doi: 10.1016/j.clpt.2004.11.046