Document Detail

Verapamil but not nifedipine impairs left ventricular function during exercise in hypertensive patients.
MedLine Citation:
PMID:  2309606     Owner:  NLM     Status:  MEDLINE    
Calcium antagonists are popular therapeutic agents in the treatment of systemic hypertension. Although these agents have similar antihypertensive efficacy, they have varied effects on left ventricular function at rest in hypertensive patients. The effect of different calcium antagonists on left ventricular function during exercise and on exercise performance in patients with hypertension, however, is less clear. Fifteen patients with essential hypertension (diastolic blood pressure = 95 to 110 mm Hg) were enrolled in a placebo-controlled, single-blinded crossover study comparing nifedipine with verapamil for rest/exercise heart rate and blood pressure, exercise performance, and rest/exercise left ventricular function. Each drug was titrated to achieve resting diastolic pressures less than 90 mm Hg. All patients underwent maximal exercise testing and rest/exercise gated radionuclide ventriculography at the end of 3-week placebo, nifedipine, and verapamil treatment periods. Both calcium antagonists significantly reduced blood pressure at rest and during exercise compared with placebo. Neither calcium antagonist altered resting heart rate; however, both verapamil and nifedipine significantly reduced heart rate at maximal exercise. Verapamil but not nifedipine impaired left ventricular peak emptying rate and left ventricular peak filling rate during exercise but not at rest. Neither verapamil nor nifedipine, however, significantly altered rest or exercise global left ventricular ejection fraction (LVEF) compared with placebo. There was a trend, however, for impairment in the LVEF response to exercise (delta LVEF) in the verapamil treatment group. Exercise capacity was not significantly altered by either calcium antagonist compared with placebo. Thus verapamil but not nifedipine impairs left ventricular function during exercise in hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)
R C Ashmore; L K Corkadel; C L Green; L D Horwitz
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  119     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1990 Mar 
Date Detail:
Created Date:  1990-03-30     Completed Date:  1990-03-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  636-41     Citation Subset:  AIM; IM    
Division of Cardiology, University of Colorado Health Sciences Center, Denver 80262.
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MeSH Terms
Blood Pressure / drug effects
Exercise / physiology
Gated Blood-Pool Imaging / drug effects
Heart Rate / drug effects
Hypertension / drug therapy*
Middle Aged
Myocardial Contraction / drug effects*
Nifedipine / therapeutic use*
Single-Blind Method
Stroke Volume / drug effects
Verapamil / therapeutic use*
Reg. No./Substance:
21829-25-4/Nifedipine; 52-53-9/Verapamil

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

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