Investigation of exercise stress by antihypertensive treatment with a combination containing beta-blocker/diuretic or reserpine.

The effects of a beta-blocker/diuretic combination and a reserpine-containing combination on exercise hypertension were compared in 20 patients suffering from mild hypertension with a diastolic pressure between 90 and 105 mmHg and a positive exercise test. This double-blind, randomized, within-patient, cross-over study involved two four-week phases, each preceded by a two-week wash-out period. The effect on the double product (tension-time index) and the physical working capacity at a heart rate of 170 bpm (PWC170) was also measured. The advantage of the preparation containing the beta-receptor blocker was apparent in both phases as physical work load increased. The PWC170 was twofold greater in the beta-receptor blocker group than in the reserpine group. The tension-time index was lowered in the normal range in both phases by the beta-blocker combination. The reserpine-containing preparation in the second phase did not further enhance the improvement produced by the beta-blocker in the first phase. These results suggest that it is worth questioning the traditional antihypertensive treatment in elderly patients, in whom mild hypertension is common, in order to better protect them from cardiovascular complications.