Drugs online research references
Schweiz Rundsch Med Prax. 1989 Nov 21;78(47):1307-9.
[The treatment of essential hypertension in the hospital and in the office: is there a difference?]
[Article in German]
Steiner A, Baettig B, Vetter W.
An identical antihypertensive regimen with Metoprolol, a beta-blocking agent, was compared in two groups of patients with mild to moderate hypertension regarding effectiveness and side effects. 17 patients were treated by practitioners, 28 patients at the university clinic. The aim of the comparison was to appreciate possible effects of the clinical setting. With respect to the blood pressure reduction no difference was found between the two groups. Significant differences were noted however regarding side-effects. The practitioners reported fewer and less serious side-effects. This observation should caution about similar phenomena in similar studies and lead to modification of planning in future studies.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2587880&dopt=Abstract
Cardiovasc Drugs Ther. 1996 Mar;10(1):67-74.
Effects of beta-blockers on HMG CoA reductase and LDL receptor activity in cultured human skin fibroblasts.
Yoshida H, Suzukawa M, Ishikawa T, Shige H, Nishio E, Hosoai H, Ayaori M, Nakamura H.
1st Department of Internal Medicine, National Defense Medical College, Saitma, Japan.
Previous reports, based on clinical trials and animal experiments, suggest that beta-blockers may be useful in the prevention of atherosclerosis. Betaxolol, a new beta1-selective blocker, was shown to decrease plasma total and LDL cholesterol levels or to have no adverse effect on those [1-4]. While many reports deal with metabolism of triglyceride and high density lipoprotein, fewer publications about cholesterol metabolism are currently available. To clarify the mechanism by which beta-blockers affect lipid metabolism, we examined the effects of beta-blockers on HMG CoA reductase and LDL receptor activity in cultured human skin fibroblasts. L-propranolol, a nonselective beta-blocker, increased HMG CoA reductase activity and decreased LDL receptor activity. However, d-propranolol had no major effects on HMG CoA reductase activity. These results suggest that beta-blockers act on HMG CoA reductase through the beta receptors. Beta1-blocking action should decrease HMG CoA reductase activity and increase LDL receptor activity. In fact, betaxolol, a beta1-selective blocker, decreased HMG CoA reductase activity and increased LDL receptor activity, but metoprolol had no major effect. We speculate that the discrepancy between betaxolol and metoprolol in the effect on HMG CoA reductase and the LDL receptor might be due to the difference of the extent of beta1-selectivity. We conclude that beta1-selective blockers are antihypertensive agents potentially valuable in the prevention of atherosclerosis.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8723172&dopt=Abstract
SMTPlink.mssm.edu
OBJECTIVE: To determine whether the acute adverse haemodynamic effects of beta blockade in patients with congestive heart failure persist during chronic treatment. DESIGN: Sequential haemodynamic evaluation of heart failure patients at baseline and after three months of continuous treatment with the beta 1 selective antagonist metoprolol. SETTING: Cardiac care unit in university hospital. PATIENTS: 26 patients with moderate to severe congestive heart failure (New York Heart Association grade II to IV) and background treatment with digoxin, diuretics, and angiotensin converting enzyme inhibitors, and with a left ventricular ejection fraction < 25%. METHODS: Baseline variables included a six minute walk, maximum oxygen consumption, and right heart catheterisation. All patients received metoprolol 6.25 mg orally twice daily initially and the dose was gradually increased to a target of 50 mg twice daily. Haemodynamic measurements were repeated after three months of treatment, both before (trough) and after drug readministration. RESULTS: Long term metoprolol had functional, exercise, and haemodynamic benefits. It produced decreases in heart rate, pulmonary capillary wedge pressure, and systemic vascular resistance, and increases in cardiac index, stroke volume index, and stroke work index. However, when full dose metoprolol was readministered during chronic treatment, there was a reduction in cardiac index (from 2.8 (SD 0.46) to 2.3 (0.38) l/min/m2, p << 0.001) and stroke work index (from 31.4 (11.1) to 26.6 (10.0) g.m/m2, p < 0.001) and an increase in systemic vascular resistance (from 943 (192) to 1160 (219) dyn.s.cm-5, p << 0.001). CONCLUSIONS: Adverse haemodynamic effects of beta blockers in heart failure persist during chronic treatment, as shown by worsening haemodynamic indices with subsequent doses.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9415001&dopt=Abstract
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