Key result
Verapamil SR and bisoprolol both abolish stress-induced BP and HR spikes in essential hypertension.
Why the study?
Does verapamil SR compared to bisoprolol reduce sympathetic nervous system activity in essential hypertensive patients?
Does verapamil SR compared to bisoprolol reduce sympathetic nervous system activity in essential hypertensive patients?
Verapamil SR and bisoprolol both lower blood pressure and reduce sympathetic nervous system activity in hypertensive patients through distinct neurohormonal mechanisms.
Answers are grounded in this paper and cite their sources.
Both agents may blunt stress-induced hemodynamic surges in hypertension; leaves open comparative efficacy for sympathetic modulation in randomized trials.
To assess the response of the sympathetic nervous system (SNS) to the handgrip test in essential hypertensive patients and to evaluate the effects of verapamil SR and bisoprolol on the reduction of the SNS's activity. Seventy eight essential hypertensive patients (50 receiving verapamil SR treatment and 28 receiving bisoprolol treatment) took the handgrip test while the SBP, DBP, and HR were measured on three occasions during the test (before test, 3 min after the patients squeezed the handgrip, and 2 min after the handgrip was released). Before and after the patients received Verapamil SR or Bisoprolol treatment, the plasma concentrations of epinephrine(E), norepinephrine (NE), angiotensin-II (AII), aldosterone (ALD), endothelin-1 (ET-1) and renin activity (RA) were measured post-test. 1) In about 70% of the essential hypertensive patients, SNS activity was above normal. Their HR and BP exceeded 20% when responding to stress. 2) In these patients, the baseline plasma concentrations of E, NE, AII, ET-1, ALD, and RA were higher than those whose SNS's activity was normal. 3) After 6 weeks of treatment, all the patients' BPs decreased remarkably. Verapamil SR could reduce the plasma concentrations of NE, AII, and ET-1 and increase RA. Bisoprolol could reduce E and RA. These two antihypertension drugs can both decrease BP and reduce the activity of SNS through different mechanisms.
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Sun et al. (2000) studied Essential hypertension (n=78). Verapamil SR and Bisoprolol vs. Baseline was evaluated on Sympathetic nervous system response to handgrip test (blood pressure, heart rate, and plasma vasoactive substances). After 6 weeks of treatment, both verapamil SR and bisoprolol abolished the stress-induced rise in blood pressure and heart rate and reduced plasma levels of vasoactive substances in patients with essential hypertension.
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