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Effects of long-term treatment with prazosin on left ventricular diastolic function in mild to moderate hypertension
C Alli1, M Di Tullio, G Mariotti
1Semeiotica Medica, University of Milan, Italy.
Insights
Blood pressure control with alpha 1-blockers did not improve diastolic function in hypertensive patients. Diastolic function showed a trend toward worsening despite reduced blood pressure, suggesting this therapy doesn't consistently affect diastolic abnormalities.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Diastolic dysfunction is an early indicator of cardiac issues in systemic hypertension.
- The impact of blood pressure control on diastolic function remains unclear.
Purpose of the Study:
- To determine if long-term treatment with an alpha 1-blocking agent can reverse left ventricular filling abnormalities.
- To assess the effect of prazosin on diastolic function in patients with essential hypertension.
Main Methods:
- Evaluated 11 never-treated patients with mild to moderate essential hypertension.
- Measured cardiac function and left ventricular mass using radionuclide ventriculography and echocardiography before and after at least six months of prazosin treatment.
- Monitored systolic and diastolic blood pressure, ejection fraction, and diastolic function indices.
Main Results:
- Significant reduction in systolic (163.54 to 146.81 mm Hg) and diastolic (106.09 to 92.90 mm Hg) blood pressure.
- Left ventricular mass showed a non-significant trend toward reduction.
- Ejection fraction remained unchanged; diastolic function indices were impaired at baseline and tended to worsen post-treatment.
Conclusions:
- Alpha 1-adrenoreceptor antagonist therapy, like prazosin, does not consistently improve or reverse diastolic dysfunction in hypertensive patients.
- Despite effective blood pressure control, diastolic function may not be favorably affected by this class of drugs.
Abstract:
It is not well established if blood pressure control is associated with an improvement in diastolic function, whose impairment represents an early marker of cardiac involvement in systemic hypertension. The purpose of this study was to evaluate whether a prolonged treatment with an alpha 1-blocking agent can lead to a reversal of the abnormalities of left ventricular filling. Eleven never-treated patients with mild to moderate essential hypertension were examined before and after at least six months of treatment with prazosin. Cardiac function and left ventricular mass were measured by means of radionuclide ventriculography and echocardiography. Average blood pressure values significantly decreased during the treatment period: from 163.54 +/- 17.80 mm Hg to 146.81 +/- 13.14 mm Hg for systolic blood pressure and from 106.09 +/- 6.96 mm Hg to 92.90 +/- 8.93 mm Hg for diastolic blood pressure. All the indices of left ventricular mass showed a trend toward reduction, but the differences with respect to the baseline values did not reach statistical significance. Average value of ejection fraction was normal before treatment and did not change significantly after treatment. All indices of diastolic function were significantly lower than normal controls' values at the beginning of the study and tended to worsen at the end of the study. Our findings suggest that diastolic function is not consistently affected by the therapy with alpha 1-adrenoreceptor antagonists despite good blood pressure control.