Ambulatory 24-hour cardiac oxygen consumption and blood pressure-heart rate variability: effects of nebivolol and valsartan alone and in combination.
Ambulatory 24-hour cardiac oxygen consumption and blood pressure-heart rate variability: effects of nebivolol and valsartan alone and in combination.
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DOI：
10.1016/j.jash.2015.03.009
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发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Osmond PJ
中科院分区：
文献类型：
--
作者：
Izzo JL Jr;Khan SU;Saleem O;Osmond PJ
我们比较了血管紧张素受体阻滞剂（缬沙坦;瓦尔）、β受体阻滞剂（奈必洛尔; NEB）和NEB/瓦尔联合用药对24小时心肌耗氧量（由24小时动态心率-中心收缩压乘积[ACRPP]测定）及其组分的影响。高血压受试者（收缩压>140或舒张压>90; n = 26）采用双盲、双模拟、强制滴定、交叉设计进行研究，3个随机顺序的实验阶段：每日瓦尔320 mg、NEB 40 mg和NEB/瓦尔320/40 mg。每种药物治疗4周后，每20分钟进行一次动态脉搏波分析（MobilOGraph），持续24小时。所有三种治疗导致几乎相同的肱动脉和中心收缩压。与瓦尔相比，NEB单独使用或与瓦尔联合使用导致ACRPP（降低11%-14%; P <0.001）和心率（降低18%-20%; P <0.001）降低，但瓦尔的每搏功（ACRPP/次搏动）降低。NEB和NEB/瓦尔组心率的相对和调整变异性（标准差和变异系数）也低于瓦尔组。非裔美国人（大多数亚群）的结果与整个治疗组的结果相似。我们得出结论，NEB的心率减慢作用导致NEB单药治疗或NEB/瓦尔联合治疗的动态心肌耗氧量低于瓦尔单药治疗。NEB/瓦尔在控制心率、血压或ACRPP方面并不上级NEB单用。NEB或NEB/瓦尔联合治疗可降低心率变异性，但不降低ACRPP变异性。在非裔美国人中，β受体阻滞剂诱导的心率减慢效应没有减弱。
We compared an angiotensin receptor blocker (valsartan; VAL), a beta-blocker (nebivolol; NEB) and the combination of NEB/VAL with respect to 24-hour myocardial oxygen consumption (determined by 24-hour ambulatory heart rate-central systolic pressure product [ACRPP]) and its components. Subjects with hypertension (systolic blood pressure >140 or diastolic blood pressure >90; n = 26) were studied in a double-blinded, double-dummy, forced-titration, crossover design with 3 random-order experimental periods: VAL 320 mg, NEB 40 mg, and NEB/VAL 320/40 mg daily. After 4 weeks of each drug, ambulatory pulse wave analysis (MobilOGraph) was performed every 20 minutes for 24 hours. All three treatments resulted in nearly identical brachial and central systolic blood pressures. NEB alone or in combination with VAL resulted in lower ACRPP (by 11%−14%; P < .001 each) and heart rate (by 18%–20%; P < .001 each) compared with VAL, but stroke work (ACRPP per beat) was lower with VAL. Relative and adjusted variability (standard deviation and coefficient of variation) of heart rate were also lower with NEB and NEB/VAL than VAL. Results in African Americans, the majority subpopulation, were similar to those of the entire treatment group. We conclude that the rate-slowing effects of NEB cause ambulatory cardiac myocardial oxygen consumption to be lower with NEB monotherapy or NEB/VAL combination therapy than with VAL monotherapy. NEB/VAL is not superior to NEB alone in controlling heart rate, blood pressure, or ACRPP. Heart rate variability but not ACRPP variability is reduced by NEB or the combination NEB/VAL. There is no attenuation of beta-blocker-induced rate-slowing effects of in African Americans.
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DOI：
10.1161/hypertensionaha.111.00138
发表时间：
2013-01
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Asayama K;Kikuya M;Schutte R;Thijs L;Hosaka M;Satoh M;Hara A;Obara T;Inoue R;Metoki H;Hirose T;Ohkubo T;Staessen JA;Imai Y
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Imai Y
影响因子：
2.8
作者：
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Davis, Barry R.
影响因子：
24
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van Veldhuisen, Dirk J.;Cohen-Solal, Alain;Flather, Marcus D.
通讯作者：
Flather, Marcus D.
影响因子：
48
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Rothwell, Peter M.;Howard, Sally C.;Sever, Peter S.
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影响因子：
120.7
作者：
Pepine, CJ;Handberg, EM;Parmley, WW
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Parmley, WW