Document Detail


Arterial dilation and reduced wave reflection. Benefit of dilevalol in hypertension.
MedLine Citation:
PMID:  2737733     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared dilevalol (an isomer of labetalol), 200-400 mg daily, against atenolol, 50-100 mg daily, in a double-blind, crossover, placebo-controlled trial with respect to effects on arterial distensibility (measured as pulse wave velocity [PWV]) and wave reflection (assessed from carotid pressure wave contour). Twelve patients of mean age 58 years (range 44-73 years) with essential hypertension (supine diastolic blood pressure 95-114 mm Hg) took active therapy for 12 weeks, separated by a 2-4 week placebo period. Carotid pressure waveforms were recorded noninvasively by applanation tonometry with a Millar micromanometer-tipped probe. PWV was measured between carotid and femoral arteries (aortic PWV), carotid and radial arteries (arm PWV), and femoral and pedal arteries (leg PWV). Early wave reflection was calculated from the ratio of the height of the peak of the carotid wave above its shoulder to the pulse pressure and was expressed as an augmentation index. Both drugs were equally effective in reducing brachial sphygmomanometric pressure and PWV in all three regions (active vs. placebo, p less than 0.001), but there was no significant difference between the two active therapies. However, the augmentation index (averaged during the treatment period) was significantly lower with dilevalol (19%) than with atenolol (28%, p less than 0.01), corresponding to a greater decrease of 5-8 mm Hg in carotid systolic pressure compared with the brachial artery. Although both drugs were equally effective in reducing arterial distensibility, the vasodilating action of dilevalol gave added benefit in reducing wave reflection, presumably through its vasodilatory effect on peripheral conduit arteries.
Authors:
R Kelly; J Daley; A Avolio; M O'Rourke
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Hypertension     Volume:  14     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-08-10     Completed Date:  1989-08-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  14-21     Citation Subset:  IM    
Affiliation:
Medical Professorial Unit, St. Vincent's Hospital, Sydney, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aorta / physiopathology
Arteries / drug effects*,  physiopathology
Atenolol / therapeutic use
Blood Pressure
Brachial Artery / physiopathology
Carotid Arteries / physiopathology
Extremities / blood supply
Female
Humans
Hypertension / drug therapy*,  physiopathology
Labetalol / therapeutic use*
Male
Middle Aged
Vasodilation / drug effects*
Chemical
Reg. No./Substance:
29122-68-7/Atenolol; 36894-69-6/Labetalol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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