The effects of rilmenidine and atenolol on mental stress, dynamic exercise and autonomic function in mild to moderate hypertension.

Panfilov, V.; Morris, Andrew D.; Donnelly, Richard; Scemama, Michel; Reid, JL

doi:10.1111/j.1365-2125.1995.tb05801.x

Cited by 12 publications

(10 citation statements)

References 23 publications

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“…To our knowledge, no study has investigated previously the role of I 1 -imidazoline receptor agonists at low doses on the hemodynamic responses to stress. It has been shown previously that chronic treatment of hypertensive patients with therapeutic doses of rilmenidine (1-2 mg/day) not only caused rest hypotension, but also, inhibited blood pressure increase during mental stress and physical exercise [27]. It is noteworthy that the potential cardioprotective effects of rilmenidine shown in the above mentioned study can also be obtained with lower doses of the drug than the ones used to treat hypertension, as observed in the present study.…”

Section: Discussionsupporting

confidence: 62%

“…Therefore, drugs able to counteract augmented sympathetic activity are potentially useful in this clinical scenario. Panfilov et al [27] compared the effects of rilmenidine and atenolol in hypertensive patients during physical and mental stress and found that these drugs exert comparable antihypertensive effects both at rest and during mental stress and dynamic exercise. However it is not known whether rilmenidine, at a dose lower than the ones recommended for the treatment of hypertension, could inhibit the hemodynamic response to stress.…”

Section: Introductionmentioning

confidence: 98%

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Reduced Hemodynamic Responses to Physical and Mental Stress Under Low-Dose Rilmenidine in Healthy Subjects

Castro

Tibiriçá

Oliveira

et al. 2006

Cardiovasc Drugs Ther

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Activation of the sympathetic nervous system plays a major role in the pathogenesis and prognosis of cardiovascular diseases. Rilmenidine is an I(1)-imidazoline receptor agonist that reduces blood pressure by modulation of central sympathetic activity, but the effects of low-dose rilmenidine on the hemodynamic responses to physiological maneuvers that increase adrenergic drive is not known. To assess the effects of low-dose rilmenidine on the hemodynamic responses to stress, 32 healthy subjects (20-56 years old) underwent acute physical exercise (n = 15, individualized ramp protocol on treadmill) and mental stress (n = 17, word color Stroop and mental arithmetics tests) two hours after the oral administration of 0.5 mg of rilmenidine (RIL) or placebo (PLA) following a randomized, double-blind, placebo controlled crossover study. No subject complained of any side effect. Rilmenidine reduced peak exercise heart rate (PLA: 187 +/- 7; RIL: 181 +/- 9 bpm; P = 0.003), but did not modify peak aerobic power (VO(2max) - PLA: 41.7 +/- 6.2; RIL: 42.3 +/- 6.7 ml/kg/min; P = 0.26). During mental stress, rilmenidine inhibited the peak systolic (PLA: 123 +/- 10; RIL: 114 +/- 8 mmHg; P = 0.02) and diastolic (PLA: 86 +/- 7; RIL: 81 +/- 7 mmHg; P <0.05) blood pressure responses. In conclusion, rilmenidine reduced the hemodynamic response to physical and mental stress stimuli without limiting exercise capacity. These results support the concept that rilmenidine, at a dose lower than the ones recommended to treat hypertension, reduced the myocardial oxygen demand to stress and may carry potential clinical impact.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 98%

Reduced Hemodynamic Responses to Physical and Mental Stress Under Low-Dose Rilmenidine in Healthy Subjects

Castro

Tibiriçá

Oliveira

et al. 2006

Cardiovasc Drugs Ther

View full text Add to dashboard Cite

show abstract

“…Nevertheless, it should be remembered that the basal levels of RSNA (or those reached during stress) were still very much lower than those observed in vehicle treated (hypertensive) rabbits. Previous studies have also shown little effect of rilmenidine on the cardiovascular responses to mental stress in hypertensive and normotensive humans [50,51]. However, administration of another centrally acting antihypertensive agent, clonidine, reduced the autonomic response to airjet stress as indicated by changes in medium frequency oscillations [52] and abolished the increased RSNA response to airjet stress in hypertensive conscious rats [53].…”

Section: Effect Of Rilmenidine On Baroreflexes During Stress and Hypementioning

confidence: 93%

Cardiac and renal baroreflex control during stress in conscious renovascular hypertensive rabbits: effect of rilmenidine

Burke

Head

2009

Journal of Hypertension

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“…Previous studies showed no effect of rilmenidine on the cardiovascular responses to mental stress in normotensive and hypertensive humans. 25,26 However, administration of another centrally acting antihypertensive agent, clonidine, reduced the autonomic response to air-jet stress as indicated by changes in medium frequency oscillations 27 and abolished the increased RSNA response to air-jet stress in hypertensive conscious rats. 28 Both of these studies are consistent with our observations that rilmenidine attenuates the sympatho-activation to air-jet stress.…”

Section: Head and Burke Sympathetic Responses In Hypertensive Rabbitsmentioning

confidence: 99%

Sympathetic Responses to Stress and Rilmenidine in 2K1C Rabbits

Head

Burke

2004

Hypertension

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Abstract-We determined whether the sympathetic excitatory responses to environmental stressors and the sympathoinhibitory responses to rilmenidine are altered by renovascular hypertension. Rabbits were made hypertensive with a clip on the right renal artery, and a left renal nerve recording electrode was implanted. After 3 or 6 weeks, the animals were given air-jet stress and loud noise stress before and after intravenous rilmenidine. Three and 6 weeks after renal clipping, mean arterial pressure was 28% and 36% greater than preclip values. Air-jet stress elicited a marked increase in renal sympathetic nerve activity, mean arterial pressure, and heart rate. Renal sympathetic nerve activity responses were much greater in hypertensive rabbits, but the pressor responses were similar to those observed in normotensive animals. Acute administration of rilmenidine decreased blood pressure more in hypertensive animals but with a much lesser inhibition of sympathetic activity. Rilmenidine markedly reduced increased sympathetic activity during air-jet stress in 3-week clipped rabbits but to a lesser extent in the other groups. These studies show that while sympathetic responses to stress were markedly enhanced in renal clip hypertensive rabbits, they did not result in greater pressor responses, thus suggesting that vascular neuroeffector mechanisms were not altered. By contrast, the increased effects of rilmenidine suggest a much greater contribution to the hypertension by the sympathetic nervous system, but one that is caused by an enhanced "nonvascular" neuroeffector mechanism. As such, sympathoinhibitory agents such as rilmenidine are very suitable and very effective agents for the treatment of renovascular hypertension. Key Words: renal nerves Ⅲ hypertension Ⅲ stress Ⅲ sympathetic nervous system Ⅲ rabbits Ⅲ blood pressure Ⅲ heart rate T here has been a long-standing interest in the role of the sympathetic nervous system in hypertension, but more so in view of increasing evidence that it can contribute to the long-term setting of blood pressure. 1 In renovascular hypertension, there is much evidence for a greater dependence of the hypertension on the sympathetic nervous system. 2 A greater depressor response to ganglion blockade has been observed in renal wrap hypertensive rats. 3 Studies in the rabbit by Cox and Bishop showed that during angiotensin (Ang) infusion, the hypertension was initially caused by Ang-mediated vasoconstriction that subsided and was replaced by a greater neurogenic component. 4 One of the major difficulties in determining the contribution of the sympathetic nervous system in hypertension has been in making direct comparisons of microvolt values between different groups. Recently, we developed a novel method for comparing sympathetic activity between groups of animals 5 and found that renal sympathetic nerve activity (RSNA) is not increased but initially decreased or unchanged in 2-kidney 1-clip (2K1C) hypertensive rabbits. 6 Studies in renal wrap 7 and chronic Ang-induced hypertension 8 support...

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The effects of rilmenidine and atenolol on mental stress, dynamic exercise and autonomic function in mild to moderate hypertension.

Cited by 12 publications

References 23 publications

Reduced Hemodynamic Responses to Physical and Mental Stress Under Low-Dose Rilmenidine in Healthy Subjects

Reduced Hemodynamic Responses to Physical and Mental Stress Under Low-Dose Rilmenidine in Healthy Subjects

Cardiac and renal baroreflex control during stress in conscious renovascular hypertensive rabbits: effect of rilmenidine

Sympathetic Responses to Stress and Rilmenidine in 2K1C Rabbits

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