Hipertansif hastalarda beta bloker, kalsiyum antagonisti, diüretik ve anjiyotensin konverting enzim inhibitörlerinin maksimal egzersizde kan basıncı kontrolündeki etkinliği

AMAÇ; Arteryel kan basıncı tek ilaçla kontrol altında tutulan esansiyel hipertansiyon olgularında maksimum treadmil egzersiz testi sırasında arteryel kan basıncı değişimini değerlendirmek. METOD: Kliniğimizde esansiyel hipertansiyon tanısıyla izlenmekte olan 125 hasta çalışmaya alındı. Hastaların 657 erkek, 60'i kadın idi. Yaş ortalaması 49.57±9.47 ve istirahat kan basınçları normal sınırlar içinde (

Efficacy of beta blockers, calcium antagonists, diuretics and angiotensin converting enzyme inhibitors in blood pressure control in hypertensive patients during maximal exercise

OBJECTIVES; We aimed to assess the changes in arterial blood pressure during treadmill stress test in patients with essential hypertension on a single antihypertensive drug. METHODS: 125 patients (65 male), with essential hypertension were included in the study. Mean age was 49.57$pm$9.47 and the resting blood pressure levels on single antihypertensive medication (25 were on beta blockers, 30 were on calcium antagonists; 32 were on diuretics, and 38 were on angiotensin converting enzyme inhibitors (ACEI)) were normal (

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  • 1-Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. The Fifth Report of the Joint National Com-mittee on Detection, Evaluation and Treatment of High Blood Pressure (JNC-V). Arch Intern Med 1993;153:154 -83.
  • 2-Marques-Vidal P, Tuomilehto J. Hypertension avvare-ness, treatment and control in the community: Is the "rule of halves" stili valid? J Hum Hyper-tens. 1997;11:213-220.
  • 3- The Joint National Committee on Prevention, Detec-tion, Evaluation, and Treatment of High Blood Pressure. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluati-on, and Treatment of High Blood Pressure. Arch Intern Med. 1997;157:2413-2446.
  • 4- Onat A, Dursunoğlu D, Sansoy V, Dönmez K, Keleş I, Ökçün B, Kahraman G. Türk Erişkinlerinde Kan Basıncında Yeni Eğilimler: TEKHARF Çalış-ması 1990 ve 1995 Verilerinin Analizi. 1996;24:147-52.
  • 5- Onat A, Sansoy V, Yıldırım B, Keleş I, Çetinkaya A, Aksu H, Uslu N, Gürbüz N. Erişkinlerimizde Kan Basıncı: 8-yıllık Seyri, Tedavi Oranı, Koro-ner Kalp Hastalığı ile ve Bazı Etkenlerle İlişkile-ri. 1999;27:211-7.
  • 6-Rudd P, Hagar W. Hypertension: mechanisms, diag-nosis and therapy. İn: Topol EJ. Textbook of Cardiovascular Medicine. Philadelphia: Lippin-cott-Raven.1998: 109-44.
  • 7-Exercise BP Response in Subjects With High-Normal BP.Exaggerated Blood Pressure Response to Exercise and Risk of Future Hypertension in Subjects With High-Normal Blood Pressu-re. Nobuyuki M, Mikio A, Ikuharu M, Kazuhisa M, Ichiro N, Shintaro T. J Am Coll Cardiol 2000;36:1626 -31.
  • 8- Franz l-W. Ergometry in Hypertensive Patients: Imp-lications for Diagnosis and Treatment. New York, Tokyo, Berlin, Heidelberg: Springer-Ver-lag, 1985.
  • 9- Chaney RH, Eyman RK. Blood pressure at rest and maximal dynamic and isometric exercise as predictors of systemic hypertension. Am J Car-diol 1988;62:1058-61.
  • 10- Singh JP, Larson MG, Manolio TA, et al. Blood pressure response during treadmill testing as a risk factor for new-onset hypertension: the Fra-mingham heart study. Circulation 1999; 99: 1831-36.
  • 11 - Kjeldsen SE, Mundal R, Sandvik L, Erikssen G, Tha-ulovv E, Erikssen J. Exercise blood pressure pre-dicts cardiovascular death and myocardial in-farction. Blood Press Monit 1997;2: 147-53.
  • 12- Neaton JD, Grimm RH Jr, Prineas RJ, Stamler J, Orandits GA, Elmer PJ, Cutler JA, Flack JM, Schoenberger JA, McDonald R, Levvis CE, Lieb-son PR, for the Treatment of Mild Hypertension Study Research Group. Treatment of mild hypertension study: final results. JAMA 1993;270:713-724.
  • 13-Materson BJ, Reda DJ, Cushman WC, Massie BM, Freis ED, Kochar MS, Hamburger RJ, Fye C, Lakshman R, Gottdiener J, Ramirez EA, Hender-son VVG, for the Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. Single-drug therapy for hypertension in men. A comparison of six antihypertensive agents vvith placebo. N Engl J Med 1993;328:914-921.
  • 14-Epstein M, Messerli FH. Combination therapy in the management of hypertensive therapy. İn: Mes-serli FH, ed. The ABC's of Antihypertensive Therapy. 2nd ed. New York: Lippincott VVilli-ams & VVilkins, 2000:204 -221.
  • 15- Messerli FH, Feng Z, Gradman AH. Combination therapy of calcium antagonists and ACE inhibi-tors—the incidence of vasodilatory edema (abstr). Am J Hypertens 1999;12(part 2):119a.
  • 16- Messerli FH, Oparil S, and Feng Z. Comparison of Efficacy and Side Effects of Combination The-rapy of Angiotensin Converting Enzyme Inhibi-tor ( Benazepril) With Calcium Antagonist (Eit-her Nifedipine or Amlodipine) Versus High-Do-se Calcium Antagonist Monotherapy for Syste-mic Hypertension. Am J Cardiol 2000;86:1182-7.
  • 17- Collins R, Peto R, MacMahon S, et al. Blood pres-sure, stroke, and coronary heart disease, part 2: short-term reductions in blood pressure oVer-vi-ew of randomised drug trials in their epidemological context. Lancet 1990; 335: 827-38.
  • 18- 9. Kostis JB, Shindler DM, Moreyra AE, et al. Diffe-rential exercise effects of captopril and nadolol in patients with essential hypertension. J Vasc Disease 1992; 647-52.
  • 19- Manhem P, Bramnert M, Hulthen UL, Hökfelt. The effect of captopril on catecho-lamines, renin activity, angiotensin II and aldosterone in plas-ma during physical exercise in hypertensive patients. Eur J Clin Invest 1981; 11: 389-95.
  • 20-Kinugawa T, Kitamura H, Ogino K. Effect of alacep-ril on blood pressure and neu-rohumoral fac-tors at rest and during dynamic exercise in pa-tients vvith essential hypertension. Br J Clin Pharmac 1992; 34: 366-9.
  • 21- Grossman E, Messerli FH, Ören S, et al. Disparate cardiovascular response to stress tests during is-radipina and fosinopril therapy. Am J Cardiol 1993; 72: 574-9.
  • 22- Psaty BM, Smith NL, Siscovick DS, et al. Health outcomes associated vvith antihypertensive the-rapies used as first-line agents: a systematic re-view and meta-analysis. JAMA 1997; 277: 739-45.
  • 23- Lahera V, Navarro-Cid J, Cachoferio V, Garcia-Es-tan J, Ruilope LM. Nitric oxide, the kidney, and hypertension. Am J Hypertens 1997;10: 1 29-40.
  • 24- Schiffrin EL, Deng LY. Comparison of effects of an-giotensin converting enzyme inhibition and b-blockade for 2 years on function of small arte-ries from hypertensive patients. Hypertension 1995;25:699 -703.
  • 25- Higashi Y, Sasaki S, Nakagavva K, Ueda T, Yoshi-mizu A, Kurisu S, Matsuura H, Kajiyama G, A Comparison of Angiotensin-Converting Enzyme Inhibitors, Calcium Antagonists, Beta-Blockers and Diuretic Agents on Reactive Hyperemia in Patients VVİth Essential Hypertension: A Multi-center Study. J Am Coll Cardiol 2000;35:284 -91
  • 26-Hornig B, Arakawa N, Haussmann D, Drexler H. Differential effects of quinaprilat and enalapri-laton endothelial function of conduit arteries in patients vvith coronary heart failure. Circulation 1998;98:2842-8.
  • 27- Hansson L, Lindholm LH, Niskanen L, et al, for the Captopril Prevention Project (CAPPP) Study Group.Effect of angiotensin converting enzyme inhibition compared vvith conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial. Lancef 1999; 353: 611-6.
  • 28- Materson BJ, Reda DJ, Cushman WC, et al. Single-drug therapy for hypertension in men: a compa-rison of six antihypertensive agents vvith place-bo. N Engl J Med 1993;328:914-21.
  • 29- Hansson L, Hedner T, Johansen PL, et al, for the NORDIL Study Group. Randomised trial of ef-fects of calcium antagonists compared vvith di-uretics and -blockers on cardiovascular morbi-dity and mortality in hypertension: the Nordic Diltiazem (NORDIL) study. Lancet 2000;356:359-65
  • 30- Hansson L, Lindholm LH, Ekbom T, et al, for the STOP-Hypertension 2 study group. Randomi-sed trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Svvedish Trial in Old Patients vvith Hypertension-2 study. Lancet 1999; 354:1751-6.
  • 31 - Marco P, Psaty BM, Alderman MH, Applegate WB, VVilliamson JD, Cavazzini C, Furberg CD. He-alth outcomes associated vvith calcium antago-nists compared vvith other first-line antihyper-tensive therapies: a meta-analysis of randomi-sed controlled trials. Lancet 2000; 356:1949-54.
  • 32- Pickering TG, Harshfield GA, Kleinert HD, et al. Blood pressure during normal daily activities, sleep and exercise. JAMA 1 982; 247: 992-8.
  • 33- Palatini P, Bongiovi S, Mario L, et al. Effects of ACE inhibition on endurance exercise haemodyna-mics in trained subjects vvith mild hypertensi-on. Eur J Clin Pharmacol 1995; 48: 435-9.
Ankara Üniversitesi Tıp Fakültesi Mecmuası-Cover
  • Başlangıç: 1947
  • Yayıncı: Erkan Mor
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