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Comparison of ketanserin and celiprolol on regression of left ventricular hypertrophy in older hypertensive patients

  • Experimental Pharmacology
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Summary

The effects of ketanserin, a specific serotonin2-receptor agonist, and celiprolol, a new, highly cardioselective % MathType!MTEF!2!1!+-% feaafeart1ev1aaatCvAUfeBSjuyZL2yd9gzLbvyNv2CaerbuLwBLn% hiov2DGi1BTfMBaeXatLxBI9gBaerbd9wDYLwzYbItLDharqqtubsr% 4rNCHbGeaGqiVu0Je9sqqrpepC0xbbL8F4rqqrFfpeea0xe9Lq-Jc9% vqaqpepm0xbba9pwe9Q8fs0-yqaqpepae9pg0FirpepeKkFr0xfr-x% fr-xb9adbaqaaeGaciGaaiaabeqaamaabaabaaGcbaGaeqOSdi2aaS% baaSqaaiaaigdaaeqaaaaa!3874!\[\beta _1 \] blocker with partial % MathType!MTEF!2!1!+-% feaafeart1ev1aaatCvAUfeBSjuyZL2yd9gzLbvyNv2CaerbuLwBLn% hiov2DGi1BTfMBaeXatLxBI9gBaerbd9wDYLwzYbItLDharqqtubsr% 4rNCHbGeaGqiVu0Je9sqqrpepC0xbbL8F4rqqrFfpeea0xe9Lq-Jc9% vqaqpepm0xbba9pwe9Q8fs0-yqaqpepae9pg0FirpepeKkFr0xfr-x% fr-xb9adbaqaaeGaciGaaiaabeqaamaabaabaaGcbaGaeqOSdi2aaS% baaSqaaiaaikdaaeqaaaaa!3875!\[\beta _2 \] agonist activity and peripheral vasodilating properties, on left ventricular (LV) structure and function were assessed in 60 older hypertensive patients (>55 years) with clinical LV hypertrophy (LV mass indes >130 g/m2). The patients were studied using echocardiography after 1 month of placebo treatment, and 6 and 18 months of monotherapy with active drug. Ketanserin and celiprolol lowered blood pressure to normal levels. Heart rate did not change with ketanserin and fell moderately (-5%) with celiprolol (p<.001). Regression of LV hypertrophy was achieved with the use of either medication (p<.0001), although the magnitude of reduction in LV mass was greater with celiprolol at both 6 months (-10% vs-5%, p=.001) and 18 months (-13% vs-7%, p=.002). While LV volume did not change with either drug, celiprolol tended to decrease it, resulting in a 5% reduction in cardiac index (p=.01), which was associated with mild bradycardia. Ketanserin did not change LV ejection fraction, whereas celiprolol caused a slight (1.5%) long-term improvement (p=.003). Systolic wall stress and total peripheral resistance decreased with both agents (p<.01), with no between-group differences. In conclusion, antihypertensive treatment of older persons with ketanserin or celiprolol achieves regression of LV hypertrophy without associated deleterious effects on LV function.

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References

  1. Kannel WB, Gordon T, Offut D, et al. Left ventricular hypertrophy by electrocardiogram. Prevalence, incidence and mortality in the Framingham study. Ann Intern Med 1969;71:89–105.

    Google Scholar 

  2. Casale PN, Devereux RB, Milner M, et al. Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. Ann Intern Med 1986;105:173–178.

    Google Scholar 

  3. Gilbert E. Pathology of hypertension. In: Goodfriend TL, ed. Hypertension essentials: Current concepts of cause and control. New York: Grune & Stratton, 1983:72–81.

    Google Scholar 

  4. Marcus ML, Koyanagi S, Harrison DG, et al. Abnormalities in the coronary circulation that occur as a consequence of cardiac hypertrophy. In: Messerli F, ed. The heart and hypertension. New York: Yorke Medical Books, 1987:231–239.

    Google Scholar 

  5. McLenachan JM, Henderson E, Morris KI, et al. Ventricular arrhythmias in patients with hypertensive left ventricular hypertrophy. N Engl J Med 1987;39:789–792.

    Google Scholar 

  6. Dunn FG, Chandrartna P, De Carvalho JGR, et al. Pathophysiologic assessment of hypertensive heart disease with echocardiography. Am J Cardiol 1977;39:789–795.

    Google Scholar 

  7. Devereux RB. Monitoring therapeutic responses with echocardiography. Drug Ther 1983;79–82, 87–88.

    Google Scholar 

  8. Fouad-Tarazi FM, Liesbon PR. Echocardiographic studies of regression of left ventricular hypertrophy in hypertension. Hypertension 1987;9(Suppl II):S65-S68.

    Google Scholar 

  9. Vanhoutte P, Amery A, Birkenhager W, et al. Serotoninergic mechanisms in hypertension. Focus on the effects of ketanserin. Hypertension 1988;2:112–133.

    Google Scholar 

  10. Vyssoulis GP, Karpanou EA, Pitsavos CE, et al. Left ventricular hypertrophy regression and function changes with ketanserin in elderly hypertensives. Cardiovasc Drugs Ther 1990;4(Suppl I):81–84.

    Google Scholar 

  11. Tarazi RC, Dustan HP. Beta-adrenergic blockade in hypertension. Am J Cardiol 1972;29:633–640.

    Google Scholar 

  12. Lund-Johansen P. Central hemodynamic effects of beta-blockers in hypertension. Eur Heart J 1983;4 (Suppl D):1–12.

    Google Scholar 

  13. Tarazi RC, Fouad FM. Reversal of cardiac hypertrophy in humans. Hypertension 1984;6 (Suppl III):140–146.

    Google Scholar 

  14. Frishman WH, Flamenbaum W, Schoenberger J, et al. Celiprolol in systemic hypertension. Am J Cardiol 1989;63:839–842.

    Google Scholar 

  15. Vyssoulis GP, Karpanou EA, Paleologos AA, et al. Left ventricular hypertrophy regression in essential hypertension with second and third generation beta-blockers (abstract). Phil J Cardiol 1990;19:I350.

    Google Scholar 

  16. Hitzenberger G. Celiprolol. Clinical dosage, efficacy and safety in asthmatics and elderly patients. Br J Clin Pract 1985;39:25–32.

    Google Scholar 

  17. Sahn DJ, DeMaria A, Kisslo J, et al. Recommendations regarding quantitation in M-mode echocardiography. Results of a survey of echocardiographic measurements. Circulation 1978;58:1072–1083.

    Google Scholar 

  18. Wallerson DC, Devereux RB. Reproducibility of echocardiographic left ventricular measurements. Hypertension 1987;9 (Suppl II):6–18.

    Google Scholar 

  19. Reichek N. Standardization in the measurement of left ventricular wall mass. M-mode echocardiography. Hypertension 1987;9 (Suppl II):27–29.

    Google Scholar 

  20. Teichholz LE, Kreulen T, Herman MV, et al. Problems in echocardiographic volume determinations. Echocardiographic-angiographic correlations in the presence or absence of asynergy. Am J Cardiol 1976;37:7–11.

    Google Scholar 

  21. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977;55:613–619.

    Google Scholar 

  22. Reichek N, Wilson J, St. John Sutton M, et al. Noninvasive determination of end-systolic stress. Validation of the method and initial application. Circulation 1982;65:99–108.

    Google Scholar 

  23. Vensel LA, Devereux RB, Pickering TG, et al. Cardiac structure and function in renovascular hypertension produced by unilateral and bilateral renal artery stenosis. Am J Cardiol 1986;58:575–582.

    Google Scholar 

  24. Lakatta EG. Is normotensive aging of the cardiovascular system a muted form of hypertensive cardiovascular disease? In: Messerli FH, ed. The heart and hypertension. New York: Yorke Medical Books, 1987:261–272.

    Google Scholar 

  25. Frohlich ED. Hypertension and cardiac involvement. In: Sonnenblick EH, Laragh JH, Lesch M, eds. New frontiers in cardiovascular therapy. New York: Elsevier, 1989:117–125.

    Google Scholar 

  26. Hedner T, Anderson O, Winther K, et al. Are there reasons to belive that the antihypertensive effects of serotonin (S2) antagonists are age-related? J Cardiovasc Pharmacol 1988;12 (Suppl 8):S132-S140.

    Google Scholar 

  27. Cobo C, Alcocer L, Chavez A. Effects of ketanserin on left ventricular hypertrophy in hypertensive patients. Cardiovasc Drugs Ther 1990;4 (Suppl 1):73–76.

    Google Scholar 

  28. Coto V, Cocozza M, Oliviero V, et al. Regression of left ventricular hypertrophy and systolic function in hypertensive patients during long-term treatment with ketanserin. Cardiovasc Drugs Ther 1990;(Suppl I):77–80.

  29. Fagard R, Fiocchi R, Lijnen P, et al. Haemodynamic and humoral responses to chronic ketanserin treatment in essential hypertension. Br Heart J 1984;8:159–172.

    Google Scholar 

  30. Taylor SH. Celiprolol and the heart. Am J Cardiol 1986;57:450–458.

    Google Scholar 

  31. Fouad-Tarazi FM, Liesbon PR. Echocardiographic studies of regression of left ventricular hypertrophy in hypertension. Hypertension 1987;9 (Suppl II):65–68.

    Google Scholar 

  32. Herrmann JM, Bischof F, von Heymann F, et al. Reduction of left ventricular hypertrophy in hypertensive patients after treatment with celiprolol. Am J Cardiol 1988;61:55C-56C.

    Google Scholar 

  33. Hansson L, Zweiffler AJ, Julius S, et al. Hemodynamic effects of acute and prolonged β-adrenergic blockade in essential hypertension. Acta Med Scand 1974;196:27–34.

    Google Scholar 

  34. Prichard BNC, Tomlinson B. The additional properties of beta adrenoreceptor blocking drugs. J Cardiovasc Pharmacol 1986;8 (Suppl 4):S1-S15.

    Google Scholar 

  35. Schoenberger J, Frishman W, Liesbon P, et al. The effects of dilevalol on left ventricular performance in hypertensive elderly patients. J Cardiovasc Pharmacol 1988;11 (Suppl 2):S38.

    Google Scholar 

  36. Gaasch WH. LV radius to wall thickness ratio. Am J Cardiol 1979;43:1189–1194.

    Google Scholar 

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Vyssoulis, G.P., Karpanou, E.A., Pitsavos, C.E. et al. Comparison of ketanserin and celiprolol on regression of left ventricular hypertrophy in older hypertensive patients. Cardiovasc Drug Ther 6, 419–424 (1992). https://doi.org/10.1007/BF00054191

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