Document Detail


Age and cardiovascular response adaptation. Determinants of an antihypertensive treatment concept primarily based on beta-blockers and calcium entry blockers.
MedLine Citation:
PMID:  6138311     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The patient's age has great impact on the development of hypertension, its duration, and severity. In patients with essential hypertension, sympathetic cardiovascular control changes from an early phase with increased beta-adrenoceptor-mediated responses, e.g., cardiac output and renin, into a later phase where these responses are blunted and alpha-adrenoceptor-mediated vasoconstriction prevails, associated with higher intracellular free sodium and calcium concentration. This pathophysiological view of essential hypertension has its corollary in the pharmacotherapeutic approach. Younger patients, who often have high renin levels, respond better to monotherapy with a beta-blocker or with a converting-enzyme inhibitor. Older patients, who often have low renin levels, respond less well to beta-blockers but particularly well to calcium entry blockers as an alternative to diuretics. Therefore, beta-blockers and calcium entry blockers form new cornerstones for antihypertensive treatment and strategy, with the potential of cardioprotection.
Authors:
F R Bühler
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hypertension     Volume:  5     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:    1983 Sep-Oct
Date Detail:
Created Date:  1983-12-17     Completed Date:  1983-12-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  III94-100     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Adult
Age Factors*
Aged
Angiotensin-Converting Enzyme Inhibitors
Antihypertensive Agents / therapeutic use*
Calcium Channel Blockers / therapeutic use*
Drug Therapy, Combination
Humans
Middle Aged
Myocardial Infarction / prevention & control
Receptors, Adrenergic / metabolism*
Renin / blood
Vasoconstriction / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Receptors, Adrenergic; EC 3.4.23.15/Renin

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