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Supine and upright haemodynamic effects of sublingual nitroglycerin and inhaled salbutamol: a double-blind, placebo-controlled, randomized study.
MedLine Citation:
PMID:  22179079     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: Pulse wave analysis is widely applied to measure the haemodynamic effects of nitroglycerin and salbutamol as an endothelium-independent and endothelium-dependent vasodilator, respectively. The recordings are usually performed in supine position from 10 to 20 successive heartbeats without simultaneous measurement of vascular resistance and cardiac function. Our objective was to examine the effects of nitroglycerin and salbutamol on central haemodynamics, arterial stiffness, cardiac function, and vascular resistance in supine and upright positions. METHODS:: A placebo-controlled, randomized and double-blinded passive head-up tilt protocol was performed after sublingual nitroglycerin (0.25 mg) or inhaled salbutamol (400 μg) in 35 healthy volunteers. Continuous tonometric pulse wave analysis, whole-body impedance cardiography, and plethysmographic finger blood pressure recordings were applied. RESULTS:: Nitroglycerin decreased aortic and finger blood pressure, radial DBP, vascular resistance, augmentation index and pulse wave velocity, and increased heart rate, cardiac index, stroke index and aortic reflection time (P < 0.030 for all). Salbutamol moderately decreased radial and aortic blood pressure and finger DBP, augmentation index and vascular resistance, but increased heart rate and cardiac index (P < 0.030 for all). Almost all of the strong haemodynamic effects of nitroglycerin were emphasized during the head-up tilt, whereas the effects of salbutamol on heart rate and cardiac index were more pronounced in the supine position. CONCLUSION:: The haemodynamic changes induced by nitroglycerin and salbutamol were dependent on body position: the effects of nitroglycerin were accentuated during the head-up tilt, whereas those of salbutamol were more evident in the supine position.
Authors:
Anna M Tahvanainen; Antti J Tikkakoski; Miia H Leskinen; Klaus Nordhausen; Mika Kähönen; Tiit Kööbi; Jukka T Mustonen; Ilkka H Pörsti
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-15
Journal Detail:
Title:  Journal of hypertension     Volume:  -     ISSN:  1473-5598     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aSchool of Medicine bSchool of Health Sciences, University of Tampere cDepartment of Clinical Physiology dDepartment of Internal Medicine, Tampere University Hospital, Tampere, Finland.
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