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Führen β-Blocker tatsächlich zu einer Zunahme des peripheren Gefäßwiderstands?

  • A. J. Man in ’t Veld
  • A. H. v.d. Meiracker
  • M. A. Schalekamp

Zusammenfassung

Heute ist allgemein anerkannt, daß ein erhöhter peripherer Gesamtwiderstand das hämodynamische Kennzeichen nahezu aller Formen der klinischen Hypertonic in alien Stadien der Erkrankung ist. Es erscheint daher logisch, diese Erkrankung mit Antihypertensiva zu behandeln, die einen oder mehrere vasokonstriktorische Mechanismen beeinflussen, um die zugrundeliegende hämodynamische Anomalie zur Umkehr zu bringen. Tatsächlich scheinen die meisten antihypertensiven Substanzklassen eine solche Wirkung auf die Widerstandsgefäße aufzuweisen. In einem neueren und umfassenden Überblick zum Thema stellte Lund- Johansen, einer der Pioniere auf dem Gebiet der hämodynamischen Forschung bei Hypertonic, 154 Arbeiten zur Hämodynamik bei Hypertonic und zu deren medikamentöser Behandlung zusammen [1]. Aus seiner Arbeit und der anderer Autoren geht hervor, daß tatsächlich die meisten Gruppen von Antihypertensiva vasokonstriktorische Mechanismen beeinflussen, da die Mehrzahl den Gefäßwiderstand bis zu einem gewissen Grad senkt (Abb. 1).

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Literatur

  1. 1.
    Lund-Johansen P (1984) Haemodynamic effects of antihypertensive agents. In: Birkenhager WH, Reid JC (eds) Handbook of Hypertension, vol 5. Clinical pharmacology of antihyperten-sive drugs. Elsevier, New York, p 3966.Google Scholar
  2. 2.
    Man in ct Veld AJ (1987) Effect of beta-blockers on vascular resistance in systemic hypertension. Am J Cardiol 59: 21F–25F.CrossRefGoogle Scholar
  3. 3.
    Man in’t Veld AJ, Schalekamp MADH (1982) How intrinsic sympathomimetic activity modulates the haemodynamic responses to beta-adrenoceptor antagonists. A clue to the nature of their antihypertensive mechanism. Br J Clin Pharmacol 13 (suppl 2): 245S–259S.Google Scholar
  4. 4.
    Man in’t Veld AJ, Schalekamp MADH (1983) Effect of 10 different beta-adrenoceptor antagonists on haemodynamics, plasma renin activity, and plasma norepinephrine in hypertension: the key role of vascular resistance changes in relation to partial agonist activity. J Cardiovasc Pharmacol 5: 530–545.Google Scholar
  5. 5.
    Man in’t Veld AJ, Schalekamp MADH (1983) Haemodynamic consequences of intrinsic sym-pathomimetic activity and cardioselectivity in beta-blocker therapy for hypertension. Eur Heart J 4(suppl D): 31–41. Google Scholar
  6. 6.
    Man in’t Veld AJ, Schalekamp MADH (1983) Haemodynamic consequences of intrinsic sym-pathomimetic activity in relation to changes in plasma renin activity and noradrenaline during beta-blocker therapy for hypertension. Postgrad Med J 59 (suppl 3): 140–158.Google Scholar
  7. 7.
    Man in ct Veld AJ, Schalekamp MADH (1983) On the antihypertensive mechanisms of beta- adrenoceptor antagonists in relation to intrinsic sympathomimetic activity, cardioselectivity and hydrophilicity. J Pharmacol Paris 14(suppl II): 69–104.Google Scholar
  8. 8.
    Man in’t Veld AJ, Schalekamp MADH (1984) Haemodynamics of beta-blockers. In: Kostis JB, De Felice EA (eds) Beta-blockers in the treatment of cardiovascular disease. Raven, New York, pp 229–251.Google Scholar
  9. 9.
    Man in’t Veld AJ, Schalekamp MADH (1984) Mechanism of action of beta-blockers in hyper-tension. In: Kostis JB, De Felice EA (eds) Beta-blockers in the treatment of cardiovascular dis-ease. Raven, New York, pp 75–93.Google Scholar
  10. 10.
    Man in’t Veld AJ, Wenting GJ, Boomsma F, Verhoeven RF, Schalekamp MADH (1980) Sym-pathetic and parasympathetic components of reflex cardiostimulation during vasodilator treatment of hypertension. Br J Clin Pharmacol 8: 547–551.Google Scholar
  11. 11.
    Man in ’t Veld AJ, Meiracker AH van den, Schalekamp MADH (1986) The effect of beta- blockers on total peripheral resistance. J Cardiovasc Pharmacol 8 (suppl 4): S49–S60.PubMedGoogle Scholar
  12. 12.
    Meiracker AH van den, Man in’t Veld AJ, Ritsema van Eck J, Wenting GJ, Schalekamp MADH (1984) Direct 24-hour haemodynamic monitoring after starting beta-blocker therapy: studies with pindolol in hypertension. J Hypertens 2 (suppl 3): 581–583.Google Scholar
  13. 13.
    Meiracker AH van den, Man in £t Veld AJ, Ritsema van Eck J, Schalekamp MADH (1986) Systemic and renal vasodilatation after beta-adrenoceptor blockade with pindolol: a haemo-dynamic study on the onset and maintenance of its antihypertensive effect. Am Heart J 112: 368–374.PubMedCrossRefGoogle Scholar
  14. 14.
    Meiracker AH van den, Man in’t Veld AJ, Ritsema van Eck HJ, Boomsma F, Derkx FHM, Mul-der P, Schalekamp MADH (1987) The clinical pharmacology of bopindolol, a new long-acting beta-adrenoceptor antagonist, in hypertension. Clin Pharmacol Ther 42: 411–419.PubMedCrossRefGoogle Scholar
  15. 15.
    Meiracker AH van den, Man in ’t Veld AJ, Schalekamp MADH (1987) Comparison of the onset of the antihypertensive action of pindolol and propranolol. A 24 hour haemodynamic study. Br J Clin Pharmacol 24 (Suppl. 1): 395–445.Google Scholar
  16. 16.
    Meiracker AH van den, Man in ’t Veld AJ, Molinoff PB, Fischberg DJ, Schalekamp MADH (1987) Effects of pindolol and propranolol on haemodynamics and lymphocyte beta-receptors in essential hypertension. J Cardiovasc Pharmacol 10 (Suppl 4): S55–S62.Google Scholar
  17. 17.
    Meiracker AH van den, Man in ’t Veld AJ, Fischberg DJ et al. (1988) Acute and long-term effects of acebutolol on systemic and renal haemodynamics, body fluid volumes, catecholamines, active renin, aldosterone and lymphocyte beta-adrenoceptor density. J Cardiovasc Pharmacol 11: 413–423.PubMedCrossRefGoogle Scholar
  18. 18.
    Muiesan G, Alcandri CL, Agabiti-Rosei E, Fariello R, Bentivoglio M, Miele N, Corea L (1978) Haemodynamic changes after prolonged therapy with methyldopa. In: Zanchetti A (ed) Methyldopa in hypertension. Waverly, Baltimore/MD, pp 107–116.Google Scholar
  19. 19.
    Safar ME, London GM, Simon AC, Weiss YA, Kheder MA, Levenson JA, Milliez PI (1978) Control of cardiac output in hypertensive patients treated with methyldopa. In: Zanchetti A (ed) Methyldopa in hypertension. Waverly, Baltimore/MD, pp 144–153.Google Scholar
  20. 20.
    Tarazi RC, Dustan HP (1972) Beta-adrenergic blockade in hypertension. Am J Cardiol 29: 633–640.PubMedCrossRefGoogle Scholar
  21. 21.
    Zacest R, Wilson LL, Robinson MA, Graham JR, Miller CDJ, O’Halloran M (1978) Clinical effectiveness and underlying haemodynamics of methyldopa, clonidine and oxprenolol in the short and long terms. In: Zanchetti A (ed) Methyldopa in hypertension. Waverly, Balti-more/MD, pp 263–276.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • A. J. Man in ’t Veld
  • A. H. v.d. Meiracker
  • M. A. Schalekamp

There are no affiliations available

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