SYSTEMIC AND PULMONARY HEMODYNAMIC-RESPONSES TO NICARDIPINE DURING GRADED ERGOMETRIC EXERCISE IN PATIENTS WITH MODERATE TO SEVERE ESSENTIAL-HYPERTENSION

[摘要] In 10 patients with moderate to severe hypertension, the hemodynamic effects of ergometric exercise and nicardipine, a dihydropyridine calcium channel antagonist, were characterized under basal conditions and after 1 week of therapy. The responses of plasma renin activity and catecholamines were also assessed. Nicardipine induced significant reductions of systolic, diastolic and mean blood pressure under conditions of rest and peak exercise (p < 0.001), mediated by reversal of vasoconstriction (p < 0.001). Overall, cardiac index and stroke volume index responses were not significantly altered by nicardipine. Although rest pulmonary wedge pressure was unchanged (6 .+-. 3 to 5 .+-. 4 mm Hg), peak exercise pulmonary wedge pressure decreased from 24 .+-. 22 to 7 .+-. 5 mm Hg (p < 0.001) with nicardipine therapy. This effect of nicardipine on pulmonary wedge pressure was present across all work loads studied, and was accompanied by reduction of peak exercise pulmonary artery pressure from 43 .+-. 10 to 25 .+-. 7 mm Hg (p < 0.001). Oxygen consumption was unchanged, associated with reduction of arteriovenous oxygen difference (p < 0.02). Both plasma renin activity (p < 0.05) and norepinephrine (p < 0.005) were significantly increased with nicardipine therapy. Thus, nicardipine produced significant blood pressure reduction by reversal of vasoconstriction in patients with essential hypertension. The preservation of cardiac output, with markedly reduced pulmonary wedge pressure, indicated that nicardipine improved ventricular performance in response to reversal of vasoconstriction.

[发布日期] 1987-09-01