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Haemodynamic effects of adrenaline during treatment of hypertensive patients with propranolol and metoprolol

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A double blind cross-over trial of propranolol and metoprolol was carried out in eight hypertensive patients. At the end of each four-week period of medication, blood pressure and heart rate at rest were measured, and the haemodynamic effects of adrenaline infusion were studied. At rest, propranolol and metroprolol reduced the blood pressure and pulse rate to the same degree. Adrenaline infusion during propranolol medication caused a marked increase both in systolic and diastolic blood pressure, the blood flow in the forearm was unchanged, and the calculated vascular resistance showed a marked increase. Adrenaline infusion during metoprolol medication caused a less marked increase in systolic blood pressure and the diastolic pressure remained unchanged. Blood flow in the forearm increased and the vascular resistance in the forearm tended to decrease. Adrenaline infusion, therefore, caused different haemodynamic effects during non-selective β-blockade with propranolol and during β1-selective blockade with metoprolol. It seems probable that the adrenaline infusion test is comparable with adrenaline release during stress situations and the results may indicate that a β1-selective blocker is to be preferred to a non-selective one as a therapeutic agent in the treatment of hypertension.

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van Herwaarden, C.L.A., Fennis, J.F.M., Binkhorst, R.A. et al. Haemodynamic effects of adrenaline during treatment of hypertensive patients with propranolol and metoprolol. Eur J Clin Pharmacol 12, 397–402 (1977). https://doi.org/10.1007/BF00561057

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Key words

  • β-Blockade
  • β1-selectivity
  • propranolol
  • metoprolol
  • adrenaline
  • haemodynamic effects
  • treatment of hypertension