Schulte W, Rüddel H, Schmieder R, Schächinger H, Bräutigam M, Welzel D
Department of Internal Medicine, University of Bonn, Germany.
J Cardiovasc Pharmacol. 1992;19 Suppl 3:S70-3.
The effects of the calcium antagonist isradipine and the beta-blocker metoprolol, which are based on different antihypertensive therapeutic principles, were evaluated in 52 men with mild-to-moderate hypertension in a 6-week, double-blind, randomized study. Mental stress-testing was performed before and after active treatment. With isradipine (n = 26), the stress-induced responses of cardiac output and total peripheral resistance were not significantly changed, but the blood pressure (BP) response, specifically the diastolic response, was decreased. With metoprolol (n = 26), there was a decreased response of cardiac output and an increased response of total peripheral resistance, and the BP response was even greater than it had been before treatment. Thus, these results indicate that beta-blockade is effective in reducing cardiac responsiveness but, because of vascular counterregulatory mechanisms, BP responsiveness is not decreased. In contrast, calcium antagonism preserves the physiological hemodynamic profile while reducing BP responsiveness to stress.
在一项为期6周的双盲随机研究中，对52名轻度至中度高血压男性患者评估了基于不同抗高血压治疗原则的钙拮抗剂伊拉地平与β受体阻滞剂美托洛尔的效果。在积极治疗前后进行了精神压力测试。使用伊拉地平（n = 26）时，心输出量和总外周阻力的应激诱导反应无显著变化，但血压（BP）反应，特别是舒张压反应降低。使用美托洛尔（n = 26）时，心输出量反应降低，总外周阻力反应增加，且血压反应甚至比治疗前更大。因此，这些结果表明，β受体阻滞在降低心脏反应性方面有效，但由于血管的反调节机制，血压反应性并未降低。相比之下，钙拮抗作用在降低血压对应激的反应性的同时，保留了生理血液动力学特征。
