Effect of intravenous propranolol on the systemic circulatory response to sustained handgrip

Macdonald, H. R.; Sapru, R. P.; Taylor, Stanley H.; Donald, K. W.

doi:10.1016/0002-9149(66)90051-8

Cited by 113 publications

(40 citation statements)

References 9 publications

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“…It has been postulated that the pressure response to the isometric exercise is reflex in origin, which serves to increase the perfusion pressure to the active muscles, in which the blood flow is impeded by the sustained muscular contraction [24]. This may be the reason for the increase in the peripheral resistance and consequently, that in the diastolic pressure in our study.…”

Section: Discussionmentioning

confidence: 52%

The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

Garg

Malhotra²,

Dhar³

et al. 2013

JCDR

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Background: A familial history of hypertension increases the risk of hypertension in the offsprings. Aims and objectives:The present study was undertaken to assess the underlying hypertension by using the Isometric Handgrip (IHG) exercise test in the offsprings of hypertensive parents and to compare it with age-matched controls of normotensive parents. Material and Methods:The isometric handgrip test was performed in the study and control groups. The resting blood pressure was recorded before exercise and afterwards the subjects were asked to perform the isometric handgrip exercise with the dominant hand for 2 minutes. Then the blood pressure was recorded in the sitting position during and 5 minutes after the completion of the exercise.Statistical Analysis: The analysis of the results was done by ANOVA with SPSS, version 17.0, by using the unpaired 't' test. Results:The results showed that the Resting Systolic (SBP), Diastolic (DBP) and the Mean (MBP) Blood Pressures were higher (p <0.001) in the offsprings of the hypertensive parents as compared to those in the control subjects of normotensive parents. During the isometric handgrip exercise test, the rise in the systolic, diastolic and the mean blood pressures was significantly higher (p<0.001) in the offsprings of the hypertensive parents. After 5 minutes of exercise, the SBP, DBP and the MBP were found to be significantly higher (p<0.001) in the study group as compared to those in the control group.Conclusions: An early and a regular screening of the children of hypertensive parents is necessary to prevent any future cardiovascular complications.

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Section: Discussionmentioning

confidence: 52%

The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

Garg

Malhotra²,

Dhar³

et al. 2013

JCDR

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“…MacDonald, Sapru, Taylor and Donald, who reported similar results during SHG, noted that propranolol may lead to unopposed vasoconstriction by virtue of its peripheral beta adrenergic blocking effect, which is manifested by an increase in vascular resistance of resting subjects (33). An alternative explanation suggests that SHG elicits vasoconstrictor activity which is unmasked or accentuated by the cardiac depressant effect of propranolol which prevents an increase in cardiac output from occurring during SHG (33). If the latter explanation is correct for the response to SHG after propranolol, one would expect a similar result following practolol, a cardioselective beta adrenergic receptor-blocking drug which depresses cardiac responses to sympathetic stimulation with the approximate effectiveness of propranolol (34)(35)(36).…”

Section: Discussionmentioning

confidence: 72%

“…There are two plausible explanations as to how this may occur. MacDonald, Sapru, Taylor and Donald, who reported similar results during SHG, noted that propranolol may lead to unopposed vasoconstriction by virtue of its peripheral beta adrenergic blocking effect, which is manifested by an increase in vascular resistance of resting subjects (33). An alternative explanation suggests that SHG elicits vasoconstrictor activity which is unmasked or accentuated by the cardiac depressant effect of propranolol which prevents an increase in cardiac output from occurring during SHG (33).…”

Section: Discussionmentioning

confidence: 95%

Autonomic Mechanisms in Hemodynamic Responses to Isometric Exercise

Martin¹,

Shaver²,

Leon³

et al. 1974

J. Clin. Invest.

203

113

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A B S T R A C T Selective autonomic blockade with intravenous propranolol, practolol, atropine, and combined atropine-propranolol was utilized to elucidate the role of the autonomic nervous system in the hemodynamic responses in young adult male volunteers to handgrip sustained at 30% of maximal voluntary contraction for 3 min. The initial 30 s of the tachycardia response was found to be mediated by withdrawal of vagal dominance, as evidenced by blockade of this response by prior atropinization. The mid and late portion of the heart rate response curve was demonstrated to be sympathetic in origin, since it was unaffected by atropine, but was suppressed by combined atropine-propranolol blockade. Sympathetic stimulation appears to be a secondary mechanism for increasing the heart rate, however, as it becomes operative only after the first mechanism of vagal withdrawal has been utilized. This was confirmed by the finding that beta adrenergic receptor blockade alone had little effect on the heart rate response curve.The pressor response to handgrip was accompanied by increased cardiac output and no change in calculated systemic vascular resistance. After propranolol, handgrip resulted in increased peripheral resistance and an equivalent rise in arterial pressure, but no increase in cardiac output. It was concluded that the increase in resistance was the result of sympathetically induced vasoconstriction. This response was shown to be independent of peripheral beta adrenergic receptor blockade by the use of practolol, a cardio-selective beta adrenergic receptor-blocking drug which caused identical hemoPortions of this study were presented previously in abstract form.

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“…The MVC was determined by taking the average of the tensions obtained by three brief maximal contractions prior to beginning the investigative phase of the study. This level of handgrip has been previously shown to produce an increase in blood pressure and heart rate in both normal and hypertensive individuals without increasing peripheral resistance (20,21).…”

Section: Methodsmentioning

confidence: 93%

Arterial hemodynamics in human hypertension.

Ting¹,

Brin²,

Lin³

et al. 1986

J. Clin. Invest.

130

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Differences in aortic impedance between normotensives and hypertensives are not well characterized. We examined impedance in 8 normotensive and 11 hypertensive (mean 96.7 vs. 122.2 mmHg) age-matched, Chinese patients undergoing cardiac catheterization at rest, during nitroprusside, and handgrip exercise before and after beta blockade (propranolol). Hypertensives had higher resistance (2,295 vs. 1713 dyn-s/cm5), characteristic impedance (145.7 vs. 93.9 dyn-s/cm5), total external power (1,579 vs. 1174 mW), peripheral reflections (ratio of backward to forward wave components of 0.54 vs. 0.44), and first zero crossing of impedance phase angle (4.15 vs. 2.97 Hz). These abnormalities were eliminated with vasodilatation. Differences between groups were not further exacerbated when pressure was increased during handgrip exercise. Beta blockade further increased resistance and reflections. Thus, hemodynamic abnormalities of essential hypertension (increased resistance, reflections, and pulse wave velocity, and decreased compliance) are compatible with an increased vasomotor tone that is further unmasked during generalized beta blockade.

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Effect of intravenous propranolol on the systemic circulatory response to sustained handgrip

Cited by 113 publications

References 9 publications

The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents

Autonomic Mechanisms in Hemodynamic Responses to Isometric Exercise

Arterial hemodynamics in human hypertension.

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