EFFECT OF METOPROLOL THERAPY ON THE ARTERIAL STIFFNESS
https://doi.org/10.20996/1819-6446-2011-7-6-685-689
Abstract
Aim. To evaluate an antihypertensive efficacy and influence on the arterial stiffness of 24-week treatment with metoprolol tartrate in patients with hypertension (HT) degree 1-2. Material and Methods. Patients with HT degree 1-2 (n=38) received therapy with metoprolol tartrate 50-200 mg QD for 24 weeks. Bifunctional daily blood pressure (BP) and electrocardiogramm monitoring with evaluation of central aortic pressure indicators as well as volume sphygmography were performed at baseline and after 24 weeks of therapy. Results. The 24-week therapy with metoprolol tartrate was effective in 47.2% of patients. Significant improvement in central aortic pressure [systolic BP decreased from 129.8±7.3 to 118.8±7.2 mm Hg; p<0.001; dyastolic BP decreased from 90 (87;93) to 80 (77;84) mm Hg; p<0.001] with the not significant changes of augmentation index (from 18.3±13.2 to 19.5±13.4; p>0.05). Significant reduction in arterial stiffness indexes was revealed with volume sphygmography: CAVI1 from 8.6 (8.1;9.6) to 8.0 (7.3;8.3); p<0.01; L-CAVI1 from 8.9 (7.6;9.9) to 7.9 (7.2;8.5), p<0.001. Conclusion. Metoprolol tartrate is an effective antihypertensive drug that improves the structural and functional properties of arteries.
About the Authors
V. E. Oleynikov
Penza State University , Institute of Medicine
Russian Federation
Russian Federation
I. B. Matrosova
Penza State University , Institute of Medicine
Russian Federation
Russian Federation
Y. A. Tomashevskaya
Penza State University , Institute of Medicine
Russian Federation
Russian Federation
L. I. Gusakovskaya
Penza State University , Institute of Medicine
Russian Federation
Russian Federation
E. A. Melnikova
Penza State University , Institute of Medicine
Russian Federation
Russian Federation
References
1. Bangalore S., Sawhney S., Messerli F.H. Relation of beta-blocker-induced heart rate lowering and cardioprotection in hypertension. J Am Coll Cardiol 2008;52:1482-9.
2. Agabiti-Rosei E., Porteri E., Rizzoni D. Arterial stiffness, hypertension, and rational use of nebivolol. Vascular Health and Risk Management 2009; 5:353-360.
3. National guidelines for diagnosis and treatment of arterial hypertension. Kardiovaskulyarnaya Terapiya i Profilaktika 2008; 7 (6) suppl 2: 1-42. Russian (Национальные рекомендации по диагоностике и лечению артериальной гипертонии. Кардиоваскулярная терапия и профилактика 2008; 7 (6) приложение 2: 1-42).
4. Pedersen M.E., Cockroft J. R. The latest generation of beta-blockers: new pharmacologic properties. Curr Hypertens Rep 2006; 8:279-286.
5. Laurent S., Cockroft J., Van Bortel L., et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588-2605.
6. Williams B., Lacy P.S., Thom S.M. et al. Anglo-Scandinavian Cardiac Outcomes Trial Investigators; CAFE Steering Committee and Writing Committee. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006;113:1213–1219.
7. De Luca N., Asmar R.G., London J.M. et al. Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide in hypertensive patient: a comparison with atenolol. Hypertension 2001; 38:922-926.
8. Ardashev V.N., Ardashev A.V. Classification of antiarrhythmic drugs. In: Ardashev AV, editor. Clinical arrhythmology. Moscow: Medpraktika, 2009: 1188-1216. Russian (Ардашев В.Н., Ардашев А.В. Классификация антиаритмических препаратов. В: Ардашев А.В., ред. Клиническая аритмология. М.: Медпрактика; 2009: 1188-1216).
9. Safar M., O'Rourke M.F. Arterial stiffness in hypertension. Edinburgh: Elsevier; 2006.
10. Yasunary K., Maeda K., Nakamura M. et al. Effects of carvedilol on oxidative stress in polymorphonuclear and mononuclear cells in patient with essential hypertension. Am J Med 2004; 116:460-465.
11. Ostroumova O.D., Dubinskaya R.E., Zhukova O.V. Correction of endothelial dysfunction in hypertension: focus on beta-blockers. Consilium Medicum 2006;8(2):17-23. Russian (Остроумова О.Д., Дубинская Р.Э., Жукова О.В. Коррекция дисфункции эндотелия при артериальной гипертонии: фокус на бета-блокаторы. Consilium Medicum 2006;8(2):17-23).
12. Metelitsa V.I. Handbook of clinical pharmacology of cardiovascular drugs. St Petersburg: Nevskiy dialekt; 2002. Russian (Метелица В.И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. СПб.: Невский диалект; 2002).
13. Hedblad В., Wikslrand J., Janzon L. el al. Low-dose metoprolol CR/XL and fluvastatin slow progression of carotid intima-media thickness (IMT): main results from the Beta-Blocker Cholester ol-Lowering Asymptomatic Plaque Study (BCAPS). Circulation 2001; 103:1721-1726.
14. Wiklund O., Hulthe J., Wlkstrand J. et al. Effect of controlled release/ extended release metoprolol on carotid intima-media thickness in patients with hypercholesterolemia: a 3-year randomized study. Stroke 2002;33:572-577.
Review
For citations:
Oleynikov V.E., Matrosova I.B., Tomashevskaya Y.A., Gusakovskaya L.I., Melnikova E.A. EFFECT OF METOPROLOL THERAPY ON THE ARTERIAL STIFFNESS. Rational Pharmacotherapy in Cardiology. 2011;7(6):685-689. (In Russ.) https://doi.org/10.20996/1819-6446-2011-7-6-685-689
Views: 752
Email this article 