The effects of alpha‐ and beta‐adrenergic receptor blockers on the pressure responses to isometric exercise in hypertensive patients.

Reuben, S R; Gale, E. V.; Blake, Pamela G.

doi:10.1111/j.1365-2125.1979.tb04720.x

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…Beta-blockers (Reuben et al, 1979;Taylor, Belfield and Taylor, 1978) as well as ablockers (Freychus, 1970;Reuben et al, 1979), are ineffective in attenuating BP rise. In their patients the present authors also demonstrated the ineffectiveness of (-blockers alone.…”

Section: Discussionmentioning

confidence: 99%

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Failure of anti-hypertensive drugs to control blood pressure rise with isometric exercise in hypertension

O’Hare¹,

Murnaghan²

1981

Postgraduate Medical Journal

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SummaryIsometric exercise causes a substantial rise in BP in normotensive and untreated hypertensives. The authors studied the isometric hand-grip test in 5 groups of treated hypertensives, namely P-blockers, P-blockers +diuretics, P-blockers +diuretics +vaso-dilators, a-methyldopa alone and labetalol. All groups showed a substantial rise in both systolic and diastolic BP, and the increments in BP differed little from that in normotensives. Some patients, despite multiple therapy, achieved increments of up to 60 mmHg from rest. Treated hypertensives with cardiac and cerebro-vascular disease are at risk performing isometric exercise. Introduction Isometric (static) exercise causes a substantial rise in systolic and diastolic BP in both normotensive and untreated hypertensive subjects (Hoel, Lorentsen and Lund-Larsen, 1970;Ewing et al., 1973). In patients with left ventricular impairment due to hypertension, coronary artery and other heart disease, isometric exercise can cause angina (Cohn et al., 1973), dangerously elevated left ventricular end-diastolic pressure (Cohn et al., 1973;Kivowitz et al., 1971;Helfant, de Villa and Meister, 1971), gallop rhythms (Fisher et al., 1975) and arrhythmias (Cohn et al., 1973). BP during isometric exercise can be extremely high in hypertensives, yet there are few studies on the effect of various anti-hypertensives in this area (Editorial, 1975).In normotensives, (-blockers alone and ablockers (Martin et al., 1974), are ineffective. In hypertensives, prazosin and propranolol (Reuben, Gale and Blake 1979) used separately are ineffective in attenuating the BP rise in isometric exercise. The authors have studied the pulse and BP changes in 47 hypertensives to determine which of 5 different drug regimes attenuate the BP rise seen with isometric exercise. Patients and methodsThe isometric hand-grip test was used in a standardized manner after Ewing et al. (1974), using a mercury sphygmomanometer (Taylor, Belfield and Taylor, 1978). The subject squeezed the partially inflated cuff at 30% of his maximum voluntary contraction until fatigue forced him to release his grip. This took a mean of 3 min (range 2-5 min). The pulse and BP (diastolic fifth phase) were measured on the non-exercising arm, before the test, at one-min intervals, and at the point of fatigue.The 47 hypertensives, 32 male and 15 female, with a mean age of 43 +16 years were on treatment for at least 3 months. None of the patients was in cardiac failure. Five treatment groups were studied: group A (n=9) patients on (-blockers alone, 7 were on propranolol and 2 on oxprenolol, mean daily dose 196+121 mg; group B (n=17) patients on (-blockers + diuretics, 14 were on propranolol, meat daily dose 200+96 mg, 9 were on thiazides and 5 on metolazone, 3 were on frusemide; group C (n= 10) patients on (-blockers + diuretics + vasodilators, 8 were on propranolol, mean daily dose 430±208 mg, 4 patients were on thiazides, 3 were on metolazone and 3 on frusemide, 5 patients were on hydrallazine, mean daily dose 160 mg, 3 were on diazo...

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Section: Discussionmentioning

confidence: 99%

“…In hypertensives, prazosin and propranolol (Reuben, Gale and Blake 1979) used separately are ineffective in attenuating the BP rise in isometric exercise. The authors have studied the pulse and BP changes in 47 hypertensives to determine which of 5 different drug regimes attenuate the BP rise seen with isometric exercise.…”

Section: Introductionmentioning

confidence: 99%

Failure of anti-hypertensive drugs to control blood pressure rise with isometric exercise in hypertension

O’Hare¹,

Murnaghan²

1981

Postgraduate Medical Journal

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The changing concept of cardiovascular reactivity

Rosenman¹,

Ward²

1988

Stress Med.

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Cardiovascular reactivity has long been measured in laboratory responses to a wide variety of cognitive and physical stressors, with the hypothesis that exaggerated reactivity plays a pathogenetic role in the development of essential hypertension. However there are few data to support the belief that behavioural differences of cognitive perception of stressors account for observed differences of reactivity. Cardiovascular reactivity in the laboratory does not predict hypertension or account for differences of blood pressure variability in the natural environment. Hypertensives do not exhibit increased blood pressure variability. Antihypertensive therapy consistently fails to lower cardiovascular reactivity in either the laboratory or natural milieu, supporting the dual and largely independent regulation of the basal and reactive blood pressures. It is concluded that there is little support for the use of laboratory stress testing to delineate either the pathogenesis of hypertension, the evaluation of hypertensive subjects, or the efficacy of antihypertensive therapy.

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Die medikamentöse Beeinflussung des Belastungshochdrucks

Gotzen¹

1986

Hochdruck Und Sport

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The effects of alpha‐ and beta‐adrenergic receptor blockers on the pressure responses to isometric exercise in hypertensive patients.

Cited by 7 publications

References 10 publications

Failure of anti-hypertensive drugs to control blood pressure rise with isometric exercise in hypertension

Failure of anti-hypertensive drugs to control blood pressure rise with isometric exercise in hypertension

The changing concept of cardiovascular reactivity

Die medikamentöse Beeinflussung des Belastungshochdrucks

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