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. 1987;24(Suppl 1):45S–49S. doi: 10.1111/j.1365-2125.1987.tb03268.x

Large arteries in hypertension

Heterogenous haemodynamic response to β-adrenoceptor antagonists with and without intrinsic sympathomimetic activity

A Ch Simon, J Levenson, I Pithois-Merli
PMCID: PMC1386208  PMID: 2894224

Abstract

1 Hypertension is associated with a distension of the large arteries and consequently a marked reduction in arterial compliance, which does not result merely from the mechanical effects of elevated arterial pressure but also from early functional and/or structural changes in the arterial walls. This suggests that one of the aims of antihypertensive therapy should be to reverse these arterial abnormalities in the hope of protecting the patient from the atherosclerotic complications of hypertension.

2 Studies have been carried out to compare the effects of equieffective antihypertensive doses of pindolol and propranolol on the arterial circulation in patients suffering from essential hypertension. After 3 months therapy pindolol produced a dilatation of the brachial artery with an increase in arterial compliance and blood flow. In contrast, propranolol, despite comparable antihypertensive effects, did not influence brachial artery circulation.

3 These different effects on the arterial circulation presumably reflect the differing pharmacological properties of the two β-adrenoceptor antagonists and suggest that the intrinsic sympathomimetic activity of pindolol may be responsible for the qualitative differences in the arterial responses to the two drugs.

4 The results reviewed here reveal that even when two drugs of the same class are used to treat patients with essential hypertension the effects of these agents on arterial haemodynamics can vary greatly and are unrelated to the degree of blood pressure lowering. Thus, pindolol, in contrast to propranolol, not only lowers blood pressure but also reverses some of the changes in arterial haemodynamics which are characteristic of hypertensive disease. Since the arterial system is one of the main targets of the disease process in hypertension these differences between the effects of antihypertensive agents on arterial function may be of importance in the choice of drugs for the long term therapy of the disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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