Document Detail

Effects of selective and nonselective beta-blockade on 24-h ambulatory blood pressure under hypobaric hypoxia at altitude.
MedLine Citation:
PMID:  21045724     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Little is known about the effects of cardiovascular drugs at high altitude.
OBJECTIVE: To assess 24-h blood pressure (BP) and heart rate (HR) during short-term altitude exposure in healthy normotensive persons treated with carvedilol or nebivolol.
METHODS: Participants were randomized in double-blind to placebo, nebivolol 5 mg once daily or carvedilol 25 mg b.i.d. Tests were performed at sea level (baseline and after 2 weeks treatment) and on second to third day at altitude (Monte Rosa, 4559 m), still on treatment. Data collection included conventional BP, 24-h ambulatory BP monitoring (ABPM), oxygen saturation (SpO2), Lake Louise Score and adverse symptoms score.
RESULTS: Twenty-four participants had complete data (36.4 ± 12.8 years, 14 men). Both beta-blockers reduced 24-h BP at sea level. At altitude 24-h BP increased in all groups, mainly due to increased night-time BP. Twenty-four-hour SBP at altitude was lower with carvedilol (116.4 ± 2.1 mmHg) than with placebo (125.8 ± 2.2 mmHg; P < 0.05) and intermediate with nebivolol (120.7 ± 2.1 mmHg; NS vs. others). Rate of nondipping increased at altitude and was lower with nebivolol than with placebo (33 vs. 71%; P = 0.065). Side effects score was higher with carvedilol than with placebo (P = 0.04), and intermediate with nebivolol. SpO2 at altitude was higher with placebo (86.1 ± 1.2%) than with nebivolol (81.7 ± 1.1%; P = 0.07) or carvedilol (81.1 ± 1.1%; P = 0.04).
CONCLUSIONS: Both carvedilol and nebivolol partly counteract the increase in BP at altitude in healthy normotensive individuals but are associated with a lower SpO2. Carvedilol seems more potent in this regard, whereas nebivolol more effectively prevents the shift to a nondipping BP profile and is better tolerated.
Grzegorz Bilo; Gianluca Caldara; Katarzyna Styczkiewicz; Miriam Revera; Carolina Lombardi; Alessia Giglio; Antonella Zambon; Giovanni Corrao; Andrea Faini; Mariaconsuelo Valentini; Giuseppe Mancia; Gianfranco Parati
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  29     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2010-12-30     Completed Date:  2011-05-04     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  380-7     Citation Subset:  IM    
Department of Cardiology, S Luca Hospital, IRCCS, Istituto Auxologico Italiano, Milan, Italy.
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MeSH Terms
Adrenergic beta-Antagonists / pharmacology
Altitude Sickness / drug therapy,  physiopathology
Anoxia / physiopathology*
Benzopyrans / pharmacology*
Blood Pressure / drug effects*,  physiology
Carbazoles / pharmacology*
Double-Blind Method
Ethanolamines / pharmacology*
Heart Rate / drug effects,  physiology
Middle Aged
Propanolamines / pharmacology*
Vasodilator Agents / pharmacology
Young Adult
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Benzopyrans; 0/Carbazoles; 0/Ethanolamines; 0/Propanolamines; 0/Vasodilator Agents; 030Y90569U/nebivolol; 0K47UL67F2/carvedilol

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

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