Nifedipine, but not propranolol, improves left ventricular systolic and diastolic function in patients with hypertension

Randall M. Zusman, Donna M. Christensen, Elizabeth B. Federman, Terrence D. Ruddy, Donald D Miller, Charles A. Boucher

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

The effects of nifedipine and propranolol on cardiac function both at rest and at peak exercise were compared in 22 hypertensive patients whose diastolic blood pressures remained in excess of 95 mm Hg despite diuretic therapy. In this double-blind, placebo-controlled study, left ventricular systolic and diastolic function at rest and at peak exercise during bicycle ergometry was assessed by first-pass radionuclide angiography using the Baird Scinticor before and after treatment with either nifedipine or propranolol. Both agents effectively reduced blood pressure in the supine and upright positions and at peak exercise. Nifedipine was associated with a significant increase in cardiac output and stroke volume at rest and at peak exercise, while propranolol decreased cardiac output at rest and at peak exercise. Systemic vascular resistance decreased with nifedipine treatment at rest and at peak exercise, but increased significantly with propranolol. Nifedipine increased ejection fraction in patients at rest and also increased maximal oxygen consumption at peak exercise, while propranolol decreased maximal oxygen consumption at peak exercise. At rest and at peak exercise, nifedipine increased peak filling rate, but time to peak filling rate was not affected by either drug. The fraction of total diastolik filling at the midpoint of diastole was significantly increased by nifedipine therapy at rest but was not affected by propranolol therapy. Nifedipine significantly decreased atrial filling volume white propranolol had no effect. Propranolol therapy did not result in any improvement in left ventricular function. In contrast, nifedipine improved left ventricular systolic and diastolic function at rest and peak exercise. Future selection of an antihypertensive agent should include consideration of the impact of therapy on left ventricular function.

Original languageEnglish (US)
JournalThe American Journal of Cardiology
Volume64
Issue number11
DOIs
StatePublished - Sep 19 1989
Externally publishedYes

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Nifedipine
Propranolol
Exercise
Hypertension
Blood Pressure
Left Ventricular Function
Oxygen Consumption
Cardiac Output
Therapeutics
First-Pass Ventriculography
Ergometry
Cardiac Volume
Diastole
Supine Position
Diuretics
Vascular Resistance
Stroke Volume
Antihypertensive Agents
Placebos

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Nifedipine, but not propranolol, improves left ventricular systolic and diastolic function in patients with hypertension. / Zusman, Randall M.; Christensen, Donna M.; Federman, Elizabeth B.; Ruddy, Terrence D.; Miller, Donald D; Boucher, Charles A.

In: The American Journal of Cardiology, Vol. 64, No. 11, 19.09.1989.

Research output: Contribution to journalArticle

Zusman, Randall M. ; Christensen, Donna M. ; Federman, Elizabeth B. ; Ruddy, Terrence D. ; Miller, Donald D ; Boucher, Charles A. / Nifedipine, but not propranolol, improves left ventricular systolic and diastolic function in patients with hypertension. In: The American Journal of Cardiology. 1989 ; Vol. 64, No. 11.
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