Document Detail


Hemodynamic and central blood pressure differences between carvedilol and valsartan added to lisinopril at rest and during exercise stress.
MedLine Citation:
PMID:  22264722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is little information about the hemodynamic and exercise-response implications of renin-angiotensin system blocker combinations. After a 3-week lisinopril (L; 40 mg/day) run-in, carvedilol (C; 20 then 40 mg/day) or valsartan (V; 160 then 320 mg/day) was added to L for 4 weeks each in a forced-titration, random order-entry crossover study in 30 subjects. Arterial tonometry (central pressures and time-tension index, TTI); impedance cardiography (steady-state hemodynamics), and ultrasound (carotid flow) were performed at rest and during supine bicycle exercise at 30 and 60 watts. At rest, both V and C lowered TTI similarly (7% to 9%, P = .05 compared with L, in part because they lowered blood pressure (3 to 7/3 to 4 mm Hg). V lowered central systolic pressure, augmentation pressure (AP), and systemic vascular resistance (SVR, all P < .02); C lowered heart rate but not central systolic pressure or SVR. During exercise, V persistently lowered central systolic pressure, AP, and SVR, whereas C did not. Neither drug affected exercise responses or carotid blood flow. Adding V or C to an angiotensin-converting enzyme inhibitor reduced cardiac workload by different mechanisms: vasodilation and reduced central blood pressure with V and lower heart rate with C.
Authors:
Joseph L Izzo; Minesh Rajpal; Shaila Karan; Sirisha Srikakarlapudi; Peter J Osmond
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-01-20
Journal Detail:
Title:  Journal of the American Society of Hypertension : JASH     Volume:  6     ISSN:  1878-7436     ISO Abbreviation:  J Am Soc Hypertens     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-03-19     Completed Date:  2012-07-24     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101312518     Medline TA:  J Am Soc Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  117-23     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, State University of New York at Buffalo, Erie County Medical Center, Buffalo, NY 14215, USA. jizzo@buffalo.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / administration & dosage
Blood Pressure / drug effects*,  physiology
Carbazoles / administration & dosage*
Cardiography, Impedance
Cross-Over Studies
Drug Therapy, Combination
Exercise / physiology
Female
Hemodynamics / drug effects*,  physiology
Humans
Hypertension / drug therapy*,  physiopathology
Lisinopril / administration & dosage*
Male
Manometry
Middle Aged
Propanolamines / administration & dosage*
Rest / physiology
Tetrazoles / administration & dosage*
Valine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Carbazoles; 0/Propanolamines; 0/Tetrazoles; 0K47UL67F2/carvedilol; 137862-53-4/valsartan; 7004-03-7/Valine; 83915-83-7/Lisinopril

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


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