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Med Clin (Barc). 1990 Sep 22;95(9):329-32.
[The clinical profile of hypertensive patients can predict the need for combining a second or third drug with atenolol in the initial treatment of light and moderate essential arterial hypertension]

[Article in Spanish]

Coca A, de la Sierra A, Sobrino J, Aguilera MT, Lluch MM, Sanchez M, Picado MJ, Urbano-Marquez A.

Grupo de Investigacion de Hipertension, Hospital Clinic i Provincial, Facultad de Medicina, Universidad de Barcelona.

In this study the clinical, biological, radiologic, electrocardiographic, and hormonal characteristics of 80 patients with slight or moderate essential arterial hypertension in whom the treatment with atenolol alone or associated with chlorthalidone or with a third agent normalized the arterial pressure during a period of one year, are revised. Atenolol given alone at the dose of 50 to 100 mg per day normalized the blood tension in 44 (55%) patients, in 26 cases (32.5%) the association of chlorthalidone 25 mg/day was required, and in the remaining 10 patients (12.5%) a third pharmacologic agent was needed. Patients who required the association of three agents (group C) had systolic arterial pressures significantly higher than those observed in patients treated with atenolol alone (group A) (176.6 +/- 14.3 vs 161.4 +/- 12.9 mmHg, p less than 0.01) and higher to those measured in patients who required the association of chlorthalidone (group B) (176.6 +/- 14.3 vs 162.8 +/- 15 mmHg, p less than 0.05). On the other hand the 44 hypertensive patients controlled with monotherapy showed a lower incidence of cardiovascular complications (6.8% in group A, 38.5% in group B, and 30% in group C, p = 0.0042), they required acute treatment for hypertensive crisis (34.1% in group A, 73.1% in group B, and 66.7% in group C, p = 0.0041), and they showed electrocardiographic signs of left ventricular hypertrophy or overload (26.2% in group A, 60% in group B, and 42.9% in group C, p = 0.0228).(ABSTRACT TRUNCATED AT 250 WORDS)

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2280617&dopt=Abstract




J Cardiovasc Pharmacol. 1986 May-Jun;8(3):559-61.
Intracellular calcium in hypertension: effect of treatment with beta-adrenoreceptor blockers.

Baumgart P, Zidek W, Schmidt W, Haecker W, Dorst KG, Vetter H.

In 41 essential hypertensive patients, the intraerythrocytic free calcium (aiCa2+) was determined before and after oral treatment with beta-adrenoreceptor blockers (atenolol, metipranolol, and pindolol). The measurements were performed by means of an ion-selective electrode. During the 4 weeks of treatment, the aiCa2+ decreased from 7.4 +/- 2.3 (mean +/- SD) to 4.1 +/- 1.7 mumol/l (p less than 0.001) in the total group of 41 patients. In the patients treated with atenolol (n,15), the aiCa2+ decreased from 7.1 +/- 1.8 to 4.4 +/- 1.7 mumol/l (p less than 0.001); in those treated with metipranolol (n,13), aiCa2+ decreased from 7.4 +/- 2.7 to 4.3 +/- 2.0 mumol/l (p less than 0.001); and in those treated with pindolol (n,13), aiCa2+ decreased from 7.6 +/- 2.4 to 3.8 +/- 1.5 mumol/l (p less than 0.001). In the total group, the mean reduction of the mean blood pressure was 12 mm Hg. In the atenolol subgroup, the blood pressure was reduced by 11 mm Hg, in the metipranolol subgroup by 15 mm Hg, and in the pindolol subgroup by 18 mm Hg. Thus, the reduction of the blood pressure during beta-adrenoreceptor blockade is accompanied by a reduction of the free calcium of the red cells. The calcium lowering effect as the antihypertensive potency is roughly equal among the different beta-adrenoreceptor blockers.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2425173&dopt=Abstract




Am J Med. 1988 Mar 11;84(3A):125-8.
Relation between cardiac hypertrophy and forearm vascular structural changes before and during long-term antihypertensive treatment.

Agabiti-Rosei E, Muiesan ML, Geri A, Romanelli G, Montani G, Muiesan G.

Clinica Medica Generale e Terapia Medica, University of Brescia, Italy.

In patients with hypertension, structural changes develop in the heart and in the systemic arteries that have a significant role in the maintenance and gradual worsening of the hypertensive disease. Blood pressure, basal and post-ischemic "maximal" forearm blood flow (strain-gauge venous occlusive plethysmography), and echocardiographic left ventricular mass index were measured in 28 hypertensive patients (WHO class I or II, 23 men and five women, aged 26 to 59 years). Minimal vascular resistance (mean arterial pressure/peak blood flow) was taken as an index of vascular structural changes. The same measurements were made in a group of 14 patients before and after long-term antihypertensive treatment: in eight patients after six and 12 months of treatment with captopril (50 mg twice a day, plus 25 mg of hydrochlorothiazide per day if necessary) and in six patients after six months of treatment with nitrendipine (20 mg per day, plus 50 mg of atenolol per day if necessary). A significant but weak direct correlation was found between the degree of left ventricular hypertrophy and mean arterial pressure (r = 0.41) or minimal vascular resistance (r = 0.31). Thus, patients were categorized according to whether they had left ventricular hypertrophy or impaired blood flow; the results suggested that left ventricular hypertrophy may be detected earlier than increased minimal vascular resistance. After six months of treatment, both captopril and nitrendipine significantly reduced left ventricular mass index and minimal vascular resistance. Left ventricular mass index was normalized in 50 percent of the patients, whereas minimal vascular resistance was normalized in one patient only. After 12 months of treatment, left ventricular mass index was normalized in all patients; minimal vascular resistance was on the average further reduced but normalized in only one additional patient. Thus, regression of cardiovascular structure also seems to occur earlier in the heart.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2975461&dopt=Abstract












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