| Hemodynamic and central blood pressure differences between carvedilol and valsartan added to lisinopril at rest and during exercise stress. | |
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MedLine Citation:
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PMID: 22264722 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Joseph L Izzo; Minesh Rajpal; Shaila Karan; Sirisha Srikakarlapudi; Peter J Osmond |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-18 |
Journal Detail:
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Title: Journal of the American Society of Hypertension : JASH Volume: - ISSN: 1933-1711 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101312518 Medline TA: J Am Soc Hypertens Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American Society of Hypertension. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine, State University of New York at Buffalo, Erie County Medical Center, Buffalo, New York. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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