The interaction of antihypertensive drugs with mechanisms of blood pressure regulation

Boudier, H. A. J. Struyker

doi:10.1016/b978-0-444-90313-6.50009-5

Pharmacology of Antihypertensive Drugs 1984

DOI: 10.1016/b978-0-444-90313-6.50009-5

|View full text |Cite

The interaction of antihypertensive drugs with mechanisms of blood pressure regulation

H. A. J. Struyker Boudier¹

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

1985

2014

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

(1 citation statement)

References 114 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, the reduced effectiveness of hydralazine as compared with captopril in preventing hypertrophic changes may be due to the increased sympathetic discharge characteristic of hydralazinetreated animals, which could counteract overall blood pressure-lowering effects. 40 The failure of propranolol treatment to prevent SMC hypertrophy may be due to a reflex increase in vasoactive tone (peripheral resistance) evoked following drug-induced decreases in cardiac output. 1340 The reduced weight gains that occurred in the propranolol-treated group may also confound data interpretation, although it is difficult to interpret what this reduced weight gain reflects and what effect it might have on aortic medial hypertrophy.…”

mentioning

confidence: 99%

Influence of blood pressure on development of aortic medial smooth muscle hypertrophy in spontaneously hypertensive rats.

Owens¹

1987

Hypertension

229

View full text Add to dashboard Cite

The hypothesis that a primary stimulus for aortic medial hypertrophy in spontaneously hypertensive rats (SHR) is increased blood pressure was tested by determining whether development of smooth muscle cell hypertrophy and hyperploidy in SHR could be dissociated from blood pressure levels in rats treated with various antihypertensive drugs with different mechanisms of action. Wistar-Kyoto rats (WKY) and SHR were treated between 2 and 5 months of age with captopril (375 mg/L), hydralazine (40 mg/L), or propranolol (1.5 mg/L) administered in their drinking water. Smooth muscle hypertrophy and hyperploidy were analyzed by morphometric evaluation of medial smooth muscle content, flow cytometric analysis of the frequency of polyploid smooth muscle cells, and biochemical estimates of smooth muscle cell number. All drugs significantly lowered blood pressure in SHR compared with untreated controls (order of efficacy: captopril greater than hydralazine greater than propranolol). Captopril also was most effective at changing blood pressure in WKY, while propranolol and hydralazine had similar blood pressure-lowering effects. The efficacy of drugs in preventing the development of smooth muscle cell polyploidism and medial hypertrophy in SHR was the same as their efficacy in lowering blood pressure, although propranolol had no effect on medial smooth muscle hypertrophy despite lowering blood pressure by 26 mm Hg. Regression analyses showed a high degree of correlation between blood pressure and the frequency of polyploid smooth muscle cells and medial smooth muscle content. These results are consistent with the hypothesis that aortic medial hypertrophy may be, in part, a response to increased blood pressure or wall stress. However, analysis of covariance and two-stage multiple regression analyses indicated that captopril had an effect over and above that predicted by its blood pressure-lowering effect. Furthermore, propranolol lowered blood pressure but did not affect medial hypertrophy. These results suggest that smooth muscle hypertrophy is not simply a response to increased blood pressure, but that other factors, such as angiotensin II, may be important in modulating aortic medial hypertrophy in SHR.

show abstract

mentioning

confidence: 99%

Influence of blood pressure on development of aortic medial smooth muscle hypertrophy in spontaneously hypertensive rats.

Owens¹

1987

Hypertension

229

View full text Add to dashboard Cite

show abstract

Individualizing Antihypertensive Combination Therapies: Clinical and Hemodynamic Considerations

Taler

2014

Curr Hypertens Rep

View full text Add to dashboard Cite

While there are strong trial data to guide the selection of initial hypertension treatment choice and limited data to support second agent choice, beyond the first two agents subsequent steps are empiric. As medications are added, the resulting polypharmacy may be complex, inefficient and poorly tolerated, resulting in low treatment adherence rates. The selection of antihypertensive drug therapy based on hemodynamic mechanisms is not new but became practical with the availability of noninvasive hemodynamic parameters using impedance cardiography. Individualized therapy based on hormonal or hemodynamic measurements can effectively control hypertension as shown in several small clinical trials. Hemodynamic measurements are obtained quickly, painlessly and can be used in a serial fashion to guide treatment adjustments. Current limitations relate to availability of the measurement device and personnel trained in its use, reimbursement for the measurements, expertise in interpretation of the measurements and systems to adjust medication and repeat measurements in a serial fashion until targets are attained. The potential utility of this approach increases with greater complexity of the medication regimen. Further studies are indicated and may advance options for individualized treatment of hypertensive patients.

show abstract

Systemic and regional hemodynamic actions of calcium entry blockers in conscious spontaneously hypertensive rats

Nievelstein

Essen

Tijssen

et al. 1985

European Journal of Pharmacology

View full text Add to dashboard Cite

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

The interaction of antihypertensive drugs with mechanisms of blood pressure regulation

Cited by 3 publications

References 114 publications

Influence of blood pressure on development of aortic medial smooth muscle hypertrophy in spontaneously hypertensive rats.

Influence of blood pressure on development of aortic medial smooth muscle hypertrophy in spontaneously hypertensive rats.

Individualizing Antihypertensive Combination Therapies: Clinical and Hemodynamic Considerations

Systemic and regional hemodynamic actions of calcium entry blockers in conscious spontaneously hypertensive rats

Contact Info

Product

Resources

About