Improvement in depressed cardiac function in hypertensive patients during pindolol treatment

Plotnick, Gary D.; Fisher, Michael L.; Wohl, Barry; Hamilton, Jennifer H.; Hamilton, Bruce P.

doi:10.1016/0002-9343(84)90740-x

Cited by 21 publications

(2 citation statements)

References 20 publications

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“…Also, in these two patients, renin concentration increased after the 5 mg dose of pindolol, whereas renin decreased in each of the remaining eight patients ( figure 3). Similar to the case for norepinephrine, baseline renin levels appear to be inversely related to the degree of hemodynamic compensation in the patients with congestive heart failure.21 22 Second, in normal subjects, /3-blockade decreases resting renin concentration and attenuates the rise in renin associated with hemodynamic stress such as upright tilt.23 In patients 6 9, this attenuation was not observed, perhaps reflecting deterioration of marginal hemodynamic compensation and a reduction in renal perfusion pressure of a magnitude sufficient to override the influence of , 3-blockade.24 Response to exercise. Previous reports in hypertensive subjects have noted an increase in peak exercise stroke volume after administration of an ISA /3-blocker.25 It has been proposed that ISA may account for this improvement through a beneficial inotropic effect on the myocardium.…”

Section: Discussionmentioning

confidence: 92%

Hemodynamic-inotropic response to beta-blocker with intrinsic sympathomimetic activity in patients with congestive cardiomyopathy.

Binkley¹,

Lewe²,

Lima³

et al. 1986

Circulation

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The rest and exercise hemodynamic-inotropic response to administration of the l3-blocker pindolol was evaluated in 10 patients with congestive cardiomyopathy to determine whether the intrinsic sympathomimetic activity (ISA) of this agent may preserve ventricular function in the setting of /3-blockade. A significant (p < .05) rise in systemic and pulmonary vascular resistance and a decline in stroke volume and cardiac index was observed after a single 10 mg dose. The change in cardiac index was negatively correlated with free drug concentration (r= -.59, p < .01); the change in pulmonary and systemic vascular resistance showed a positive correlation with plasma concentration (r = .67, r-.57, respectively; all p < .05). The response to exercise reflected a predominant /3-blocking effect, with a significant decrease in peak heart rate and cardiac index and an increase in pulmonary vascular resistance. There were no significant changes in variables of right or left ventricular inotropy after administration of the drug. The mean baseline plasma norepinephrine concentration for the population was 609 + 172 pg/ml (normal = 196 + 7 pg/ml) and was markedly elevated in two patients (931 and 2053 pg/ml) who developed severe pindolol-induced hypotension. Renin increased markedly in these two patients, but decreased in each of the remaining eight patients. These data indicate that although inotropy is not adversely affected by pindolol, increased afterload, which appears to be mediated by peripheral /3-blockade, results in a reduction in ventricular performance.

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Section: Discussionmentioning

confidence: 92%

Hemodynamic-inotropic response to beta-blocker with intrinsic sympathomimetic activity in patients with congestive cardiomyopathy.

Binkley¹,

Lewe²,

Lima³

et al. 1986

Circulation

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“…However, several controlled haemodynamic studies of patients with stable angina pectoris or acute myocardial infarction have thrown light on this problem. Thus, beta-blocking drugs that have intrinsic sympathomimetic activity (ISA, also called partial agonist activity, PAA) appear to be more effective in maintaining cardiac function than drugs without this property (18)(19)(20)(21)(22)(23)(24)(25)(26).…”

Section: Beta Blockadementioning

confidence: 99%

Rationale for Treating Angina Pectoris in Patients with Heart Failure

Heikkilä

1985

Journal of Internal Medicine

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Use of β ‐ Adrenergic Receptor Blockers in Blacks

Prisant

Mensah

1996

The Journal of Clinical Pharma

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Beta adrenergic receptor blockers (beta-blockers) are an important class of drugs in the management of patients with cardiovascular diseases. These drugs have been shown to reduce mortality in hypertension and prolong survival in patients with coronary heart disease. Although hypertension and coronary heart disease account for the majority of excess cardiovascular morbidity and mortality in blocks, beta-blockers continue to be underprescribed in this ethnic group. The magnitude of blood pressure reduction in black patients with hypertension has been consistently less during monotherapy with nonselective beta-blockers than with diuretics. However, the highly selective beta-blocker bisoprolol has been shown to be as effective as diuretics and is equally effective in black and nonblack patients with hypertension. In general, no racial differences in efficacy are noted when beta-blockers are used with diuretics as combination therapy for hypertension. Black patients should not be denied beta-blocker therapy because of an anticipated suboptimal response, especially when there are clear indications for treatment (e.g., for migraine, hyperthyroidism, arrhythmia control, and after myocardial infarction).

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Improvement in depressed cardiac function in hypertensive patients during pindolol treatment

Cited by 21 publications

References 20 publications

Hemodynamic-inotropic response to beta-blocker with intrinsic sympathomimetic activity in patients with congestive cardiomyopathy.

Hemodynamic-inotropic response to beta-blocker with intrinsic sympathomimetic activity in patients with congestive cardiomyopathy.

Rationale for Treating Angina Pectoris in Patients with Heart Failure

Use of β ‐ Adrenergic Receptor Blockers in Blacks

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