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Cardiac morphology and function in arterial hypertension. The effects of a new multifactorial hypotensive agent:
S Ghione1, A Genovesi-Ebert, C Marabotti
1CNR Institute of Clinical Physiology, Università di Pisa, Italy.
Insights
Urapidil effectively lowers blood pressure by reducing peripheral resistance without impacting heart rate. This antihypertensive agent shows a positive trend in reducing cardiac hypertrophy and preserves cardiac function.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Assessing antihypertensive agents' impact on cardiac hemodynamics is crucial.
- Ideal hypotensive drugs should reduce peripheral resistance without altering cardiac output.
- Normalization of left ventricular hypertrophy and preserved cardiac function are desired outcomes.
Purpose of the Study:
- To review the effects of urapidil on cardiac hemodynamic profile in patients under chronic treatment.
- To evaluate urapidil's impact on blood pressure, cardiac output, and cardiac hypertrophy.
- To assess changes in left ventricular function (systolic and diastolic) during urapidil treatment.
Main Methods:
- A series of studies employing echocardiography were reviewed.
- Echocardiography was used to investigate cardiac variables in patients receiving chronic urapidil treatment.
- Blood pressure, heart rate, cardiac output, left ventricular hypertrophy indices, and cardiac function were assessed.
Main Results:
- Urapidil significantly decreased blood pressure within one month by reducing peripheral resistances, with no change in heart rate.
- A trend towards reduced cardiac hypertrophy was observed, with significant decrements in measured indices.
- Left ventricular dimensions remained largely unchanged, and systolic/diastolic function was preserved, with some improvement noted after 12 months.
Conclusions:
- Urapidil effectively lowers blood pressure through decreased peripheral resistance.
- The drug favorably impacts cardiac morphology, suggesting a reduction in cardiac hypertrophy.
- Urapidil appears to preserve and potentially improve left ventricular function during chronic treatment.
Abstract:
It has been recognized as increasingly important to determine whether antihypertensive agents, while satisfactorily lowering the blood pressure, at the same time adversely or positively affect the cardiac hemodynamic profile. On theoretical grounds, one would expect that an ideal hypotensive drug should decrease blood pressure by decreasing total peripheral resistances, without affecting cardiac output, and should normalize left ventricular hypertrophy without deteriorating systolic or diastolic left ventricular function. We here briefly review the effects of urapidil on these variables in patients under chronic treatment investigated in a series of studies employing echocardiography. The results of the studies are in fair agreement and indicate a blood pressure decrease already after one month of treatment, due to a decrease of peripheral resistances, without changes in heart rate. A clear trend towards a reduction of cardiac hypertrophy during the treatment is suggested by the significant decrements of the indices measured. One study also suggests that right ventricular wall thickness may be reduced. Left ventricular dimensions remained unchanged in all except one study. Systolic and diastolic function indices were also unchanged during the first 6 months of treatment and, in one study, improvement was found after 12 months of treatment. Taken together these results suggest that urapidil lowers blood pressure favorably, affecting cardiac morphology and function.