| Discordant beta-blocker effects on clinic, ambulatory, resting, and exercise hemodynamics in patients with hypertension. | |
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MedLine Citation:
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PMID: 16945046 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVES: To determine the correlation between ambulatory and clinic blood pressure in assessing antihypertensive response to beta-blockade, to test whether blood pressure response to metoprolol is associated with the heart rate response, and to determine whether exercise and resting heart rate responses to metoprolol are correlated. DESIGN: Post hoc analysis of a prospective cohort study. SETTING: University-affiliated general clinical research center. PATIENTS: Fifty-one patients aged 35-65 years with uncomplicated hypertension. Intervention. All patients received metoprolol at a dosage titrated to achieve a diastolic blood pressure below 90 mm Hg. MEASUREMENTS AND MAIN RESULTS: Clinic and 24-hour ambulatory blood pressure measurements were obtained and exercise treadmill testing was performed before and after metoprolol treatment. Based on ambulatory blood pressure data, 24 patients (47%) responded (defined as at least a 10% reduction in diastolic blood pressure) to metoprolol compared with 36 patients (71%) based on clinic blood pressure data (p=0.027). Clinic blood pressure was associated with a 67% false-positive rate (responsive blood pressure by clinic data that was actually nonresponsive by ambulatory data). Blood pressure responders and nonresponders exhibited similar reductions in exercise heart rate (24% and 23%, p=0.74). However, responses to metoprolol measured by exercise heart rate versus resting heart rate were not significantly correlated (r=0.24, p=0.105). CONCLUSION: Reliance on clinic blood pressure or resting heart rate for making beta-blocker treatment decisions may yield less than optimal assessment of the antihypertensive response or degree of beta-blockade. |
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Authors:
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Amber L Beitelshees; Issam Zineh; Hossein N Yarandi; Daniel F Pauly; Julie A Johnson |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pharmacotherapy Volume: 26 ISSN: 0277-0008 ISO Abbreviation: Pharmacotherapy Publication Date: 2006 Sep |
Date Detail:
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Created Date: 2006-09-01 Completed Date: 2007-01-10 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 8111305 Medline TA: Pharmacotherapy Country: United States |
Other Details:
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Languages: eng Pagination: 1247-54 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Practice, College of Pharmacy, University of Florida, Gainesville, Florida 32610-0486, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Adult Aged Ambulatory Care Facilities Antihypertensive Agents / therapeutic use* Blood Pressure Exercise / physiology Female Heart Rate Humans Hypertension / drug therapy*, physiopathology Male Metoprolol / therapeutic use* Middle Aged |
| Grant Support | |
ID/Acronym/Agency:
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HL64691/HL/NHLBI NIH HHS; HL68834/HL/NHLBI NIH HHS; RR00082/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 37350-58-6/Metoprolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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