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Influence of drugs on blood pressure variability
D L Clement1, M De Buyzere, D D Duprez
1University Hospital, Department of Cardiovascular Diseases, Gent, Belgium.
Aim:
To study the causes of blood pressure variability by using antihypertensive drugs.
Methods:
Survey of published studies.
Results:
The results are sometimes unclear and, for some drugs, contradictory. beta-Adrenoceptor antagonists appear to have no effect on blood pressure variability, whereas alpha-adrenoceptor antagonists and atropine can lessen the amplitude of the variations. Similarly, there is a decrease after the administration of clonidine. Guanfacine, however, which acts on the same central receptors, does not lessen variability. Calcium antagonists do not influence blood pressure variability and the results with angiotensin converting enzyme inhibitors are contradictory.
Conclusions:
From these results we conclude that blood pressure variability is not dependent on beta-receptor activity or calcium-mediated mechanisms. It is most likely that both alpha-adrenergic tone and the vagal system have significant effects on blood pressure variability.