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Hemodynamic effects of verapamil in essential hypertension at rest and during exercise
Insights
Verapamil, a calcium antagonist, effectively lowers blood pressure in essential hypertension patients. Long-term treatment significantly reduces arterial pressure and total peripheral resistance, with a notable decrease in heart rate during exercise.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a common condition often treated with calcium antagonists.
- Long-term hemodynamic effects of verapamil in hypertension require further elucidation.
Purpose of the Study:
- To investigate the long-term hemodynamic effects of verapamil in patients with essential hypertension.
- To assess changes in blood pressure, heart rate, and peripheral resistance at rest and during exercise.
Main Methods:
- Ten male patients with WHO stage I essential hypertension were studied.
- Hemodynamic parameters including oxygen consumption, heart rate, cardiac output, and arterial pressure were measured at rest and during graded exercise.
- Patients received verapamil (120-240 mg daily) for one year, and measurements were repeated.
Main Results:
- Verapamil treatment led to a statistically significant reduction in systolic, diastolic, and mean arterial pressure (approx. 10% at rest, less during exercise).
- A significant reduction in total peripheral resistance was observed at rest, with a modest reduction during exercise.
- Heart rate remained unchanged at supine rest but decreased by approximately 8% when sitting and during exercise.
Conclusions:
- Verapamil is an effective long-term treatment for essential hypertension, reducing blood pressure and peripheral resistance.
- The drug also demonstrates a beneficial effect on heart rate, particularly during physical activity.
Abstract:
In recent years the calcium antagonist verapamil has been used in the treatment of essential hypertension. Relatively little work has been done to elucidate its long-term haemodynamic effects at rest and during exercise. Ten males with previously untreated essential hypertension in WHO stage I, aged 35-55 years, were studied on an outpatient basis. Oxygen consumption, heart rate, cardiac output ( Cardiogreen ) and intra-arterial brachial pressure were recorded at rest in the supine and sitting position and during steady state work at 50, 100 and 150 W. As expected, the hypertension was associated with an increase in total peripheral resistance. The subjects were treated with verapamil 120-240 mg daily as the sole drug for one year. The haemodynamic study was then repeated. One subject demonstrated a slight increase in blood pressure at rest and during exercise, while there was a blood pressure reduction in the other 9. The nonresponding patient was excluded from the statistical evaluation. The main results were as follows: There was a statistically significant reduction in systolic, diastolic and mean arterial pressure at rest as well as during exercise. The reductions reached about 10% at rest, slightly less during exercise. The blood pressure reduction was associated with a statistically significant reduction in total peripheral resistance at rest only. During exercise, the reduction in resistance was modest (about 5%). The heart rate was practically unchanged during supine rest, but decreased about 8% at rest sitting and during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)