Influence of captopril, propranolol, and verapamil on arterial pulse wave velocity and other cardiovascular parameters in healthy volunteers.

OBJECTIVE

The effects of antihypertensive agents on cardiovascular parameters, especially on arterial pulse wave velocity, remain largely unknown in normotensive subjects. Therefore, the present investigation was designed to evaluate acute effects of ACE inhibitor captopril,beta-adrenoceptor blocker propranolol and calcium entry blocker verapamil on cardiovascular and ventilatory function in healthy volunteers.

MATERIAL

The influence of single doses of captopril (25 mg), propranolol (40 mg), and verapamil (80 mg) on cardiovascular function and exercise capacity were compared in healthy volunteers in a randomized, double-blind, placebo-controlled fashion.

METHODS

Cardiac output and beat-by-beat blood pressure were estimated non-invasively before and after the drug administrations by whole-body impedance cardiography and Finapres finger blood pressure monitoring, respectively. Arterial pulse wave velocity was obtained from the time delay between flow pulses measured from the root of the aorta and the popliteal artery, and systemic vascular resistance was calculated from cardiac output and mean arterial pressure. In addition, a progressive maximal exercise test was performed after the treatments.

RESULTS

Propranolol reduced heart rate, cardiac output and arterial pulse wave velocity, and increased systemic vascular resistance clearly more effectively than placebo. In addition, captopril effectively decreased arterial resistance and pulse wave velocity. However, the influence of verapamil on cardiovascular parameters did not significantly differ from those observed in placebo-treated subjects. Exercise peak heart rate, peak blood pressure, and minute ventilation were reduced in subjects treated with propranolol, but not in those treated with captopril and verapamil, when compared to placebo.

CONCLUSIONS

Acute administration of captopril and propranolol but not verapamil clearly modulated cardiovascular parameters in rest, suggesting differential effects of these compounds on cardiovascular function in healthy volunteers. These drugs seem to have disparate effects on arterial pulse wave propagation as an indicator of arterial compliance after short-term administration in healthy subjects. Captopril and verapamil had no effect on cardiovascular and ventilatory function during maximal exercise, while propranolol markedly altered also these variables in the present study.