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Published on: May 19, 2021

Dilated cardiomyopathy with hypertension: prevalence and response to high-dose β1-adrenoceptor antagonist therapy

Xiaolin Zheng1, Shuzhen Chen, Jinju Wang

  • 1Department of Cardiology, Xiangya Hospital of Central South University, Changsha 410008, China.

Clinical and Experimental Pharmacology & Physiology
|May 29, 2009
PubMed

Insights

Hypertension is more common in dilated cardiomyopathy (DCM) patients. Those with hypertension tolerated and responded better to higher doses of metoprolol, suggesting increased sympathetic activity.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Dilated cardiomyopathy (DCM) is a significant cardiac condition.
  • Hypertension is a common comorbidity with potential impacts on DCM management.
  • Understanding the interplay between hypertension and DCM is crucial for effective treatment.

Purpose of the Study:

  • To determine the prevalence of hypertension in patients with dilated cardiomyopathy (DCM).
  • To assess the long-term tolerance and efficacy of high-dose metoprolol in DCM patients, particularly those with hypertension.
  • To explore potential differences in response to metoprolol based on hypertensive status in DCM.

Main Methods:

  • Comparative analysis of hypertension prevalence in DCM patients (n=362) versus age-matched controls (n=401).
  • Subgroup analysis of DCM patients into hypertensive (DCM-H) and normotensive (DCM-N) groups.
  • Longitudinal assessment of metoprolol's effects (dose, blood pressure, heart rate, cardiac dimensions, ejection fraction) over 12 months.

Main Results:

  • Hypertension prevalence was significantly higher in DCM patients (32.8%) compared to controls (20.1%).
  • DCM patients with hypertension (DCM-H) showed higher resting heart rate and a family history of hypertension.
  • Higher metoprolol doses were tolerated and more effective in the DCM-H group, improving cardiac function metrics.

Conclusions:

  • Dilated cardiomyopathy patients exhibit a greater prevalence of hypertension.
  • Hypertensive DCM patients demonstrate increased tolerance and responsiveness to higher metoprolol dosages.
  • These findings suggest higher sympathetic nervous system activity in hypertensive DCM patients, supporting higher-dose metoprolol therapy.

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