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Effect of celiprolol on cardiac hypertrophy in hypertension
Insights
Celiprolol and atenolol, both beta-blockers, reduced left ventricular hypertrophy and improved heart function in spontaneously hypertensive rats. Celiprolol also regressed left ventricular hypertrophy in hypertensive patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a significant risk factor for cardiovascular disease, often leading to left ventricular hypertrophy (LVH).
- Beta-blockers are commonly used to manage hypertension, but their effects on cardiac remodeling and ischemic damage can vary.
- Intrinsic sympathomimetic activity (ISA) is a property of some beta-blockers that may influence their cardiovascular effects.
Purpose of the Study:
- To investigate the effects of celiprolol (a beta1-selective beta-blocker with ISA) and atenolol (a beta1-selective beta-blocker without ISA) on ischemic damage in the hearts of spontaneously hypertensive rats (SHR).
- To evaluate the long-term efficacy of celiprolol in reducing left ventricular hypertrophy (LVH) in patients with essential hypertension.
Main Methods:
- SHR were treated with atenolol (50 mg/kg/day) or celiprolol (300 mg/kg/day) for 7 weeks to assess effects on blood pressure, heart rate, and cardiac function following ischemia-reperfusion.
- Essential hypertensive patients with LVH received celiprolol treatment for 12 months, with measurements of interventricular septal thickness (IVST), LV posterior wall thickness (PWT), and LV mass index (LVMI) taken at intervals.
Main Results:
- Both atenolol and celiprolol significantly reduced blood pressure and LV weight to body weight ratio in SHR, with similar improvements in coronary reserve and recovery of pressure-rate product and coronary flow post-ischemia.
- Celiprolol treatment in hypertensive patients significantly decreased IVST+PWT and LVMI, indicating LVH regression, with significant reductions observed by 3 months and further decreases at 6 and 12 months.
- No significant correlation was found between blood pressure and LVH indices before or after celiprolol treatment in patients.
Conclusions:
- Both celiprolol and atenolol demonstrate cardioprotective effects by reducing LVH and improving ischemic damage in SHR.
- Celiprolol effectively reduces blood pressure and induces significant regression of LVH in patients with essential hypertension and existing LVH.
Abstract:
The present study was undertaken to clarify whether celiprolol and atenolol, beta1-selective beta blockers with and without intrinsic sympathomimetic activity (ISA), respectively, might improve ischemic damage in the isolated perfused hearts of spontaneously hypertensive rats (SHR), and whether long-term treatment with celiprolol may reduce left ventricular hypertrophy (LVH) in patients with essential hypertension. Atenolol (50 mg/kg/day) or celiprolol (300 mg/kg/day) for 7 weeks significantly reduced the blood pressure in SHR to the same degree, and both drugs decreased the heart rate, but the magnitude of the fall in heart rate was significantly higher with atenolol treatment than with celiprolol treatment. Both treatments significantly reduced the ratio of LV weight to body weight in SHR and significantly improved the coronary reserve in SHR to the same extent. Both treatments significantly improved the extent of recovery of the pressure-rate product and the extent of percent recovery of the coronary flow after reperfusion following 30 min of ischemia in SHR. Celiprolol treatment in patients with essential hypertension for 12 months significantly decreased interventricular septal thickness (IVST)+LV posterior wall thickness (PWT) and LV mass index (LVMI), but there was no significant correlation between IVST+PWT or LVMI and blood pressure before and after treatment. IVST+PWT and LVMI were significantly decreased after 3 months of treatment and these LVH indices were significantly smaller after 6 and 12 months of treatment than after 3 months of treatment. In conclusion, both celiprolol and atenolol treatment reduced LVH and improved the ischemic damage in SHR. In essential hypertensive patients with LVH, celiprolol treatment effectively reduced blood pressure and achieved LVH regression.