Related Experiment Videos
Postprandial Hemodynamic Changes in Hypertensives Treated with Calcium Antagonists or ACE Inhibitors
V. Musumice1, S. Di Salvo, U. Campia
1Cattedra di Medicina Interna, CLOPD.
Insights
Hypertension medications impact post-meal blood pressure changes differently. Angiotensin-converting enzyme inhibitors caused significant drops, while calcium antagonists showed blunted effects in hypertensive patients.
Area of Science:
- Cardiovascular Physiology
- Pharmacology
Background:
- Hypertension management often involves vasodilating drugs.
- Postprandial hemodynamic changes can differ among individuals.
Purpose of the Study:
- To investigate postprandial hemodynamic variations in hypertensive patients treated with ACE inhibitors or calcium antagonists.
- To compare these changes with those in healthy individuals.
Main Methods:
- Utilized impedance cardiography and automatic blood pressure monitoring.
- Monitored cardiac output and blood pressure for 5 hours around lunchtime in 11 healthy subjects and 22 hypertensive patients.
- Patients were treated with either angiotensin-converting enzyme inhibitors (ACEI) or calcium antagonists.
Main Results:
- ACEI-treated hypertensives showed a significant postprandial decrease in mean arterial pressure (-7.9%) compared to calcium antagonist-treated patients (-3.7%) and normotensives (-2.7%).
- ACEI group exhibited a larger postprandial reduction in total peripheral resistance and a greater heart rate increase than normotensives.
- Postprandial hemodynamic changes were blunted and non-significant in hypertensive patients treated with calcium antagonists.
Conclusions:
- Different antihypertensive medications, specifically ACE inhibitors and calcium antagonists, exert distinct effects on postprandial hemodynamic responses.
- These findings highlight the differential impact of drug classes on cardiovascular regulation after meals.
Abstract:
Our aim was to investigate possible abnormalities in postprandial hemodynamic changes in hypertensives treated with different vasodilating drugs, calcium antagonists, or angiotensin-converting enzyme inhibitors. Eleven healthy subjects and 22 hypertensive patients effectively treated with an angio tensin-converting enzyme inhibitor (ACEI) (n = 9) or calcium antagonists (n = 13) were studied. Cardiac output and blood pressure were monitored every 20 min from 2 h before lunch to 3 h after using a computer-assisted impedance cardiograph coupled with an automatic blood pressure monitor. After meals, a significant decrease in mean arterial pressure (minus sign7.9% plus minus 2.1) was observed in ACEI-treated hypertensives when compared with the minor changes observed in calcium-antagonist-treated hypertensives (minus sign3.7% plus minus 1.5) and in normotensives (minus sign2.7% plus minus 1.5). When compared with normotensives, the patients treated with ACEI showed a larger postprandial fall in total peripheral resistance index (minus sign20.8% plus minus 3.4 versus minus sign15.3% plus minus 4.1) with a larger increase in heart rate (11.3% plus minus 2.3 versus 8.1% plus minus 1.3). In hypertensives treated with calcium antagonists, the postprandial hemodynamic changes appeared blunted and not significant. Different antihypertensive drugs appear to have different effects on the postprandial hemodynamic changes.