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Haemodynamic comparison of amlodipine and atenolol in essential hypertension using the quantascope
Author(s) -
THAM T.C.K.,
HERITY N.,
GUY S.,
SILKE B.
Publication year - 1993
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1993.tb00414.x
Subject(s) - atenolol , amlodipine , medicine , blood pressure , stroke volume , heart rate , cardiology , vasodilation , anesthesia , essential hypertension
1 We have utilised a non‐imaging echo‐Doppler cardiac output device, using the principle of attenuated compensation volume flow (ACVF), to assess the cardiovascular effects of amlodipine and atenolol over 3 months in 24 patients with essential hypertension. 2 Both amlodipine and atenolol, at 4 and 12 weeks, similarly reduced mean arterial pressure (12 weeks amlodipine −12.6 mmHg, atenolol −14.9 mmHg; P < 0.01 for each vs baseline). 3 The heart rate fell on atenolol, both at 4 weeks (amlodipine −3 vs atenolol −12 beats min −1 ; P < 0.05) and 12 weeks (−1 vs −11 beats min −1 ; P < 0.05), without change on amlodipine. 4 Stroke volume initially rose on atenolol without change on amlodipine (4 weeks amlodipine −1.3 ml vs atenolol +10.1 ml; P = 0.05) but between drug effects were not different at 12 weeks. 5 The systemic vascular resistance was reduced on amlodipine (12 weeks: amlodipine −176 dyn s cm −5 : P < 0.05) without change on atenolol (atenolol −48 dyn s cm −5 : NS). 6 The cardiac stroke work was lowered on amlodipine both at 4 weeks ( P < 0.01) and 12 weeks ( P < 0.05) and statistically different from the unaltered atenolol values at both time points. 7 Skin nutrient flow or fingertip temperature was not altered by either treatment. 8 These results are consistent with contrasting mechanisms of action — vasodilator for amlodipine and decreased cardiac pumping for atenolol. The greater reduction in cardiac stroke work on amlodipine compared with atenolol warrants further investigation during longer‐term studies.