Key result
Changing to pindolol increased hand blood flow and decreased sensitivity to cold in 8 of 9 hypertensive patients with cold extremities, whereas adding prazosin had no effect.
Why the study?
Does adding prazosin or switching to pindolol improve hand blood flow and cold sensitivity in hypertensive patients experiencing cold extremities on standard beta-blockers?
Does adding prazosin or switching to pindolol improve hand blood flow and cold sensitivity in hypertensive patients experiencing cold extremities on standard beta-blockers?
Switching to a beta-blocker with intrinsic sympathomimetic activity (pindolol) effectively relieves cold extremities induced by standard beta-blockers, whereas adding a vasodilator (prazosin) does not.
Answers are grounded in this paper and cite their sources.
Pindolol switch may relieve beta-blocker-induced cold extremities; hypothesis-generating and should not yet change practice.
Hand blood flow and subjective sensitivity to cold were studied in nine hypertensive patients on treatment with beta-blockers. All patients complained of cold extremities. Neither hand blood flow nor sensitivity to cold changed after addition of prazosin, a well known vasodilator to the original beta-blocker. After changing to a beta-blocker with a high degree of intrinsic sympathomimetic activity (pindolol), hand blood flow increased and sensitivity to cold decreased in all patients, except one.
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Ohlsson et al. (1981) studied Hypertension with cold extremities on beta-blockers (n=9). Pindolol vs. Original beta-blocker and prazosin was evaluated on Hand blood flow and subjective sensitivity to cold. Changing to pindolol increased hand blood flow and decreased sensitivity to cold in 8 of 9 hypertensive patients with cold extremities, whereas adding prazosin had no effect.
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