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Hemodynamic changes induced by cilazapril and atenolol during isometric stress in hypertensive patients

P Pancera1, E Arosio, F Priante

  • 1Clinica Medica, Università di Verona, Italy.

International Journal of Clinical Pharmacology, Therapy, and Toxicology
|December 1, 1993
PubMed

Insights

Cilazapril, an ACE inhibitor, and atenolol, a beta-blocker, both lower blood pressure in hypertensive patients. Cilazapril showed faster action and improved reactive hyperemia post-exercise, while atenolol reduced heart rate.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Essential hypertension is a prevalent cardiovascular condition.
  • Hemodynamic assessment is crucial for evaluating antihypertensive treatments.

Purpose of the Study:

  • To compare the hemodynamic effects of cilazapril (ACE inhibitor) and atenolol (beta-blocker) in patients with essential hypertension.
  • To assess the impact of these drugs on brachial and carotid artery hemodynamics during isometric stress.

Main Methods:

  • A study involving 16 patients with mild to moderate essential hypertension.
  • Administration of cilazapril (5 mg daily) and atenolol (100 mg daily) over three months.
  • Evaluation of hemodynamic parameters including blood pressure, heart rate, forearm compliance, characteristic impedance, and reactive hyperemia after an isometric handgrip stress test.

Main Results:

  • Both cilazapril and atenolol significantly decreased blood pressure after three months; cilazapril demonstrated an immediate effect after the first dose.
  • Atenolol significantly reduced heart rate, whereas cilazapril did not.
  • Forearm compliance and characteristic impedance showed significant changes with both treatments, both acutely and after three months.
  • Cilazapril uniquely increased reactive hyperemia after handgrip exercise.

Conclusions:

  • Cilazapril and atenolol are effective in managing essential hypertension, with differing acute and long-term hemodynamic profiles.
  • Cilazapril may offer advantages in improving post-exercise vascular function (reactive hyperemia).
  • The choice between ACE inhibitors and beta-blockers may depend on specific patient needs regarding heart rate control and vascular reactivity.

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