Advertisement

Die medikamentöse Beeinflussung des Belastungshochdrucks

  • R. Gotzen
Conference paper

Zusammenfassung

Für die medikamentöse Therapie der arteriellen Hypertonie steht heute eine große Anzahl von Pharmaka zur Verfügung, deren gute antihypertensive Wirkung bei der Behandlung des erhöhten Ruheblutdrucks bewiesen ist. Es stellt sich jedoch die Frage, ob die Effizienz einer antihypertensiven Therapie allein an der Senkung des Ruheblutdrucks beurteilt werden kann. Vorliegende Befunde sprechen dafür, daß Blutdruckanstiege bei alltäglichen Belastungen (körperlicher und psychischer Streß) für die kardiovaskulären Folgeerkrankungen der arteriellen Hypertonie Bedeutung haben könnten. Von Interesse ist deshalb die Frage, welche Einflüsse die heute verfügbaren Antihypertensiva auf den Belastungshochdruck haben.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Äärynen M, Mäkela M, Hämeenaho P, Mattila MJ (1981) Prazosin enhances the antihyperten-sive effects of beta-blockers during isometric and dynamic exercise. Ann Clin Research 13: 71–76Google Scholar
  2. 2.
    Bateman DN, Dean CR, Mucklow JC, Bulpitt CJ, Dollery CT (1979) Atenolol and Chlorthali-done in combination for hypertension. Br J Clin Pharmac 7: 357–363Google Scholar
  3. 3.
    Dunn FG, Melivlle DI, Jones JV, Lorimer AR, Lawrie TDV (1978) Standardized stress and hypertension: Comparison of effect of propranolol and methyldopa. Br J Clin Pharmac 5: 223–226Google Scholar
  4. 4.
    Ekelund LG, Ekelund C, Rössner S (1982) Antihypertensive effects at rest and during exercise of a calcium blocker, nifedipine alone and in combination with metoprolol. Acta Med Scand 212: 71–75PubMedCrossRefGoogle Scholar
  5. 5.
    Falkern B, Questi G, Affrime MB, Lowenthal DT (1982) The effect of a centrally acting agent versus diuretics on the cardiovascular response to mental stress in adolescent hypertension. Abstract Ninth scientific meeting of the International Society of Hypertension. Mexico CityGoogle Scholar
  6. 6.
    Falkner B, Onesti G, Affrime MB, Löwenthal DT (1982) Effects of Clonidine and hydrochlorothiazide on the cardiovascular response to mental stress in adolescent hypertension. Clin Sci 63: 455s–548sGoogle Scholar
  7. 7.
    Francois B, Cahen R, Gravejat MF, Estrade M (1984) Do betablockers prevent pressor responses to mental stress and physical exercise. Eur Heart J 5: 348–353PubMedGoogle Scholar
  8. 8.
    Franz I-W, Lohmann FW (1978) Die Bedeutung der ergometrischen Untersuchung zur Beurteilung der antihypertensiven Therapie. Dtsch Med Wochenschr 38: 1478–1486CrossRefGoogle Scholar
  9. 9.
    Franz I-W (1984) Ergometrie bei Hochdruck- und Koronarkranken in der täglichen Praxis. Springer Verlag Berlin, Heidelberg, New York S. 103–132Google Scholar
  10. 10.
    Franz I-W, Wiewel D (1984) Nitrendipine, Nifedipine and Acebutolol in hypertension. J Cardiovasc Pharmacol 6 (Suppl 7): 1037–1042CrossRefGoogle Scholar
  11. 11.
    Götzen R, Schulte K-L, Thiede HM, Meyer-Sabellek WA (1983) Metabolie effects of acebutolol in combination with mefruside. In P. Lichtlen, M. F. C. Maranhao: Advances in betablocker therapy III, F. K. Schattauer, Stuttgart New York, S164Google Scholar
  12. 12.
    Gould BA, Hornung RS, Mann S, Raftery EB (1982) Slow channel inhibitors Verapamil and nifedipine in the management of hypertension. J Cardiovasc Pharmacol 4: S 369–S 372Google Scholar
  13. 13.
    Harris L, Dargie HJ, Lynch PG, Bulpitt J, Krikler DM (1982) Blood pressure and heart rate in patients with ischemic heart disease receiving nifedipin and propranolol. Brit Med J 284: 1148–1151CrossRefGoogle Scholar
  14. 14.
    Heidbreder E, Ziegler A, Heidland A (1982) Verhindern sympatholytische Antihypertensiva den Blutdruckanstieg bei mentalem Streß? Herz/Kreislauf 3: 135–141Google Scholar
  15. 15.
    Houben H, Thien Th, de Boo Th, Lemmens W, Binkhorst R, van t’Laar A (1983) Hemodynamic effects of isometric exercise and mental arithmetric in hypertension treated with selective and nonselective betablockade. Clin Pharmacol Ther 34: 164–169Google Scholar
  16. 16.
    Koch G (1981) Hemodynamic changes after acute and long-term combined alpha-betaadreno- receptor blockade with labetalol as compared with betareceptor blockade. J Cardiovasc Pharmacol 3 (Suppl 1): 30–41CrossRefGoogle Scholar
  17. 17.
    Lorimer AR, Barbour MB, Lawrie TDV (1983) An evaluation of the effect on resting and exercise blood pressure of some first line treatment in hypertension. Ann Clin Res 15: 30–34PubMedGoogle Scholar
  18. 18.
    Lund-Johansen P (1967) Hemodynamics in early essential hypertension. Acta Med Scand (Suppl 482 ): 1–15Google Scholar
  19. 19.
    Lund-Johansen P (1970) Hemodynamik changes in long-term diuretic therapy of essential hypertension. Acta Med Scand 187: 509–518PubMedCrossRefGoogle Scholar
  20. 20.
    Lund-Johansen P (1972) Hemodynamic changes in long-term alphamethyldopa therapy of essential hypertension. Acta Med Scand 192: 221–226PubMedCrossRefGoogle Scholar
  21. 21.
    Lund-Johansen P (1973) Hemodynamic alterations in essential hypertension. In: Onesti G, Kim KE, Moyer JH (eds) Hypertension and management. Grune & Stratton, New York, p 43Google Scholar
  22. 22.
    Lund-Johansen P (1974) Hemodynamic changes at rest and during exercise in long-term prazo-sin therapy of essential hypertension. In: Cotton DKW (Hrsg) Prazosin - Evaluation of a new antihypertensive agent. Excerpta Medica, Amsterdam, p 43Google Scholar
  23. 23.
    Lund-Johansen P (1974) Hemodynamic changes at rest and during exercise in long-term beta- blocker therapy of essential hypertension. Acta Med Scand 195: 117–121PubMedCrossRefGoogle Scholar
  24. 24.
    Lund-Johansen P (1976) Hemodynamic long-term effects of timolol at rest and during exercise in essential hypertension. Acta Med Scand 199: 263–269PubMedCrossRefGoogle Scholar
  25. 25.
    Lund-Johansen P (1976) Hemodynamic long-term effects of a new beta-adrenoceptor blocking drug, atenolol (ICI 66082) in essential hypertension. Br J Clin Pharmacol 3: 445–450PubMedGoogle Scholar
  26. 26.
    Lund-Johansen P (1976) Hemodynamic effects of Clonidine in man. In: Onest G, Fernandes M, Kim KE (eds) Regulation of blood pressure by the central nervous system. Grune & Stratton, New York, p 355Google Scholar
  27. 27.
    Lund-Johansen P, Ohm O-J (1977) Haemodynamic long-term effects of metoprolol at rest and during exercise in essential hypertension. Br J Clin Pharmacol 4: 147–151PubMedGoogle Scholar
  28. 28.
    Lund-Johansen P (1977) Central hemodynamics in essential hypertension. Acta Med Scand (Suppl 606 )Google Scholar
  29. 29.
    Lund-Johansen P (1978) Haemodynamic long-term effects of prazosin plus tolamolol in essen-tial hypertension. Br J Clin Pharmacol 4: 141–145Google Scholar
  30. 30.
    Lund-Johansen P (1978) Spontaneous changes in central hemodynamics in essential hypertension - a 10 year follow up study. In Onesti G, Klimt R (Hrsg) Hypertension: determinants, complications and intervention. Grune & Stratton, New York, p 50–65Google Scholar
  31. 31.
    Lund-Johansen P (1979) Long-term hemodynamic effects of bunitrolol at rest and during exer-cise in essential hypertension. J Cardiovasc Pharmacol 1: 77–81PubMedCrossRefGoogle Scholar
  32. 32.
    Lund-Johansen P (1979) Long-term hemodynamic effects of Penbutolol at rest and during exercise in essential hypertension. Eur J Clin Pharmacol 16: 149–155PubMedCrossRefGoogle Scholar
  33. 33.
    Lund-Johansen P (1979) Hemodynamic consequences of long-term betablocker-therapy; A 5 year follow-up study of atenolol. J Cardiovasc Pharmacol 1: 487–492PubMedCrossRefGoogle Scholar
  34. 34.
    Lund-Johansen P, Bakke OM (1979) Haemodynamic effects and plasma concentrations of labe- talol during long-term treatment of essential hypertension. Br J Clin Pharmacol 7: 169–174PubMedGoogle Scholar
  35. 35.
    Lund-Johansen P (1981) Hemodynamic long-term effects of tielinic acid. Acta Med Scand (Suppl): 70–75Google Scholar
  36. 36.
    Lund-Johansen P (1981) Hämodynamik bei der essentiellen Hypertonie in Ruhe und während Ergometrie und deren Beeinflussung durch Diuretika, ß-Rezeptorenblocker und Vasodilatato- ren. In: Franz I-W (Hrsg) Belastungsblutdruck bei Hochdruckkranken. S107 - 123. Springer, Berlin Heidelberg New YorkGoogle Scholar
  37. 37.
    Lund-Johansen P (1983) Haemodynamic effects of verapamil in essential hypertension at rest and during exercise. Acta Med Scand Suppl 681: 109–118Google Scholar
  38. 38.
    Lund-Johansen P, Omvik P (1984) Long-term effects of Enapapril at rest and during exercise in essential hypertension. J Hypertension 2 (Suppl 2): 49–55Google Scholar
  39. 39.
    Magnani B, Brosioni EA, Costa FV, Malini PL, Mageiii C (1979) Comparison of antihyperten-sive activity of atenolol and methyldopa at rest and during exercise. Int J Pharmacol Therapy Tox 19: 440–444Google Scholar
  40. 40.
    Manhem P, Hökfelt B (1981) Prolonged Clonidin treatment. Acta Med Scand 209: 253–260PubMedCrossRefGoogle Scholar
  41. 41.
    Manhem P, Bramnert M, Hulthén UL, Hökfelt B (1981) The effect of Captopril on catecholamines, renin activity, angiotensin II and aldosterone in plasma during physical exercise in hypertensive patients. Eur J Clin Invest 11: 389–395PubMedCrossRefGoogle Scholar
  42. 42.
    McAllister RG (1979) Effects of adrenergic receptor blockade on the response to ergometrie handgrips: Studies in normal and hypertensive patients subjects. J Cardiovasc Pharmacol 1: 253–263PubMedCrossRefGoogle Scholar
  43. 43.
    Middeke M, Burkhart A, Holzgreve H (1983) Blutdruckverhalten während dynamischer und isometrischer Belastungen unter antihypertensiver Langzeittherapie mit Beta-Rezeptorenblok- kern und Diuretika. Klin Wochenschr 61: 1241–1248PubMedCrossRefGoogle Scholar
  44. 44.
    Miller AJ, Kaplan MB, Upton MT, Grais JM, Abrams DL (1983) Treadmill exercise testing in hypertensive patients with Hydrochlorothiazide and beta blocking drugs. JAMA 250: 67–70PubMedCrossRefGoogle Scholar
  45. 45.
    Nyberg G (1976) Effects of ß-adrenoreceptor blockers on heart rate and blood pressure in dynamic and isometric exercise. Drugs 11 (Suppl 1): 185–195PubMedCrossRefGoogle Scholar
  46. 46.
    Patyna WD (1981) Die Beeinflussung des Blutdruckverhaltens Hochdruckkranker während Er- gometrie durch eine Reserpin-Diuretikum-Kombination und ß-Rezeptorenblocker. In: Franz I- W(Hrsg): Belastungsblutdruck bei Hochdruckkranken. S139 - 144. Springer, Berlin Heidelberg New YorkGoogle Scholar
  47. 47.
    Pickering ThG, Case DB, Sullivan PA, Laragh HH (1982) Comparison of antihypertensive and hormonal effects of Captopril and propranolol at rest and during exercise. Am J Cardiol 49: 1566–1568PubMedCrossRefGoogle Scholar
  48. 48.
    Reuben SR, Gale EV, Blake P (1979) The effects of alpha- and beta-adrenergic receptor blockers on the pressure responses to isometric exercise in hypertensive patients. Br J Clin Pharmacol 8: 365–370PubMedGoogle Scholar
  49. 49.
    Sangvik K, Strokkeland M, Lindseth-Ditlefsen EM, Nyberg G (1975) Circulation reaction at rest and during isometric and dynamic exercise in hypertensive patients: influence of different adrenergic beta-adrenoceptor antagonists. Pharmatherapeutika 1: 71–78Google Scholar
  50. 50.
    Schulte K-L, Meyer-Sabellek WA, Distler A, Götzen R (1983) Blutdrucksenkende Wirkung der Kalziumantagonisten Nifedipin und Diltiazem bei essentieller Hypertonie in Ruhe und unter ergometrischer Belastung. Verh Dtsch Ges Inn Med 81: 1047–1049Google Scholar
  51. 51.
    Stoker JB, Greeharan N, Linden RJ, Barbour MP, Lorimer AR, Hillis WS, Lawrie TDV (1979) Effects of exercise in hypertension controlled with metoprolol or methyldopa. Clin Sci 57: S391–S392Google Scholar
  52. 52.
    Virtanen K, Jänne J, Frick MH (1982) Response of blood pressure and plasma norepinephrine to propranolol, metoprolol and Clonidine during isometric and dynamic exercise in hypertensive patients. Eur J Clin Pharmacol 21: 275–279PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • R. Gotzen
    • 1
  1. 1.Medizinische Klinik und PoliklinikKlinikum Steglitz der Freien Universität BerlinBerlin 45Germany

Personalised recommendations