Standardized stress and hypertension: comparison of effect of propranolol and methyldopa.

Abstract

1 Using a standardized form of mental stress, 21 patients with idiopathic hypertension were investigated before and after treatment with placebo (n=8), propranolol (n=7) or methyldopa (n=6). 2 Blood pressure was satisfactorily controlled in the propranolol and methyldopa groups but only the propranolol group showed modification of the pressor response to stress testing. 3 These results suggest that propranolol may provide more uniform control of blood pressure than methyldopa in patients with essential hypertension.

Responses to mental stress and physical provocations before and during long term treatment of hypertensive patients with beta‐adrenoceptor blockers or hydrochlorothiazide.

“…We found that ,-adrenoceptor blockade clearly reduced (by 50-70%) the heart rate responses to CWT, in agreement with previous findings concerning the effects of acute (Eliasch et al, 1967;Bonelli et al, 1979) and chronic 1adrenoceptor blockade (Guazzi et al, 1976;Nyberg et al, 1977;Dunn et al, 1978;Heidbreder etal., 1978;Houben etal., 1983;Francois et al, 1984;Floras et al, 1985) on responses to other mental stressors. Adaptation is not a major problem with CWT, as is sometimes the case with other mental stress tests, since heart rate responses to CWT have been found to be similar on three occasions during a 3 month period in placebo-treated post-infarction patients (Olsson et al, 1986).…”

“…Our findings of unchanged blood pressure responsiveness to stress during 3-adrenoceptor blockade, despite attenuated heart rate responsiveness and clearly reduced blood pressure levels, are in agreement with previous findings with oral treatment with non-selective 1-adrenoceptor antagonists (Nyberg et al, 1977;Houben et al, 1983;Floras et al, 1985) or 1l-selective antagonists (Nyberg et al, 1977;Heidbreder etal., 1978;Waal-Manning & Bolli, 1980;Houben et al, 1983;Francois et al, 1984;Floras et al, 1985) for varying periods of time. Only two studies have reported decreases in blood pressure reactivity to mental stress during 3-adrenoceptor blockade (Guazzi et al, 1976;Dunn et al, 1978), but the possibility of adaptation to the stress procedure was not investigated in these studies. A study of intraarterially recorded blood pressures during the stress of driving found a reduction of blood pressure levels, but no alteration of reactivity (Millar-Craig et al, 1981), in agreement with our results.…”

Objective Measurement of Performance during Acute Stress in Patients with Essential Hypertension: Assessment of the Effects of Propranolol and Metoprolol

“…We have previously shown modification of blood pressure rise by propranolol with a form of chronic industrial stress (Dunn, Melville, Jones, Lorimer & Lawrie, 1978). That study differed from the one reported here not only in that a different type of stress was used but also in that blood pressure was normalized with propranolol before re-studying.…”

Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives.

“…Reducing cardiovascular reactivity to stress in hypertensives has seldom been examined systematically, but methods studied to date have included pharmacological treatment with beta-blockers and nonpharmacological interventions of relaxation/desensitization and biofeedback-assisted relaxation. Although beta-blockers have been successful in reducing reactivity in normotensives (Imhof, Blatter, Fuccela, & Turri, 1969) and hypertensives (Dunn, Melville, Jones, Lorimer, & Laurie, 1978; Schmeider, Friedrich, Neus, Rudel, & von Eiff, 1983), all antihypertensive agents have been associated with troublesome side effects in some patients (Lasser et al, 1984). Nonpharmacological treatments are therefore recommended for initial intervention in mild hypertension (Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, 1984).…”