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Hemodynamic interaction of nonselective vs. beta‐1‐selective beta‐blockade with hydralazine in normal humans
Author(s) -
Reeves Richard A,
Smith Donna L,
Leenen Frans H H
Publication year - 1987
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 - 10.1038/clpt.1987.35
Subject(s) - hydralazine , afterload , propranolol , atenolol , venous return curve , medicine , heart rate , hyperdynamic circulation , cardiac output , cardiology , hemodynamics , blockade , anesthesia , vascular resistance , blood pressure , receptor
To assess the effects of nonselective vs. β 1 ‐selective β‐blockade on the hyperdynamic circulation induced by hydralazine, eight healthy volunteers received placebo, propranolol, 20 and 40 mg, and atenolol, 25 and 50 mg, on 5 separate days, followed by hydralazine (range 75 to 150 mg). Hydralazine decreased afterload (end‐systolic wall stress) and increased venous return and left ventricular performance (by M‐mode echocardiography). Both β‐blockers blunted the increases in heart rate, cardiac output, and venous return similarly, although heart rate and cardiac output were not completely normalized. Atenolol did not affect the hydralazine‐induced decrease in afterload, whereas propranolol significantly opposed this change (P < 0.03). The hyperdynamic circulation seen with hydralazine is mostly β mediated, primarily β 1 . When given with hydralazine the two β‐blocker types differ primarily in their effects on afterload. Clinical Pharmacology and Therapeutics (1987) 41, 326–335; doi: 10.1038/clpt.1987.35