Effect of cadralazine on brachial artery hemodynamics and forearm venous tone in essential hypertension

Forearm venous tone and brachial artery hemodynamics, including determinations of the arterial diameter and compliance by the use of pulsed Doppler systems, were measured in 16 patients with sustained essential hypertension before and after acute oral cadralazine dosing. Systolic and diastolic blood pressures significantly decreased, whereas heart rate increased. Brachial artery diameter and vascular resistance decreased, respectively, from 0.501 +/- 0.015 to 0.485 +/- 0.015 cm (P less than 0.001) and from 124.8 +/- 13.8 to 99.3 +/- 11.9 mm Hg/ml . sec (P less than 0.01). Blood flow velocity increased (P less than 0.05) but volumic flow, pulse wave velocity, and brachial artery compliance did not change. Forearm venous tone increased but the increase was inversely related to the degree of arteriolar vasodilatation. Our results indicate that, with cadralazine, forearm vascular resistance decreased while forearm blood flow was unchanged, the dilatation of small arteries contrasted with a significant reduction in the diameter of the large brachial artery, and the decrease in blood pressure was associated with a lack of increase in arterial compliance and changes in venous tone. This suggests an overriding influence of the activation of the autonomic nervous system on the action of cadralazine on large arteries and veins.