Pharmacy Practice Faculty Publications
Antihypertensive Effect of Alpha- and Beta-Adrenergic Blockade in Obese and Lean Hypertensive Subjects
Document Type
Article
Publication Date
7-2001
Journal Title
American Journal of Hypertension
ISSN
0895-7061
Volume
14
Issue
7 Pt 1
First Page
694
Last Page
698
DOI
http://dx.doi.org/10.1016/s0895-7061(01)01293-6
PubMed ID
11465655
Abstract
The purpose of this study was to determine the contribution of the adrenergic system in mediating hypertension in obese and lean patients. Thirteen obese, hypertensive patients with a body mass index (BMI) ≥28 kg/m2(obese) and nine lean patients with a BMI ≤25 kg/m2 (lean) were recruited. After a 1-week washout period, participants underwent daytime ambulatory blood pressure monitoring (ABPM). Participants were then treated with the α-adrenergic antagonist doxazosin, titrating to 4 mg QHS in 1 week. In the next week, the β-adrenergic antagonist atenolol was added at an initial dose of 25 mg/day and titrated to 50 mg/day within 1 week. One month after the addition of atenolol, all patients underwent a second ABPM session.
There were no differences between the obese and lean subjects in baseline systolic (SBP), diastolic (DBP), or mean arterial pressures (MAP) measured by office recording or ABPM. However, obese subjects had higher heart rates than lean subjects (87.5 ± 2.4 v 76.8 ± 4.9 beats/min). After 1 month of treatment with the adrenergic blockers, obese patients had a significantly lower SBP (130.0 ± 2.5 v 138.9 ± 2.1 mm Hg, P = .02) and MAP (99.6 ± 2.3 v 107.0 ± 1.5 mm Hg, P = .02) than lean patients. Obese patients also tended to have a lower DBP than lean patients (84.3 ± 2.5 v 90.9 ± 1.6 mm Hg, P = .057), but there was no significant difference in heart rate after 1 month of adrenergic blockade.
These results indicate that blood pressure is more sensitive to adrenergic blockade in obese than in lean hypertensive patients and suggest that increased sympathetic activity may be an important factor in the maintenance of hypertension in obesity.
Keywords
Adrenergic alpha-antagonists, adrenergic beta-antagonists, adult, atenolol, blood pressure monitoring, ambulatory, doxazosin, female, humans, hypertension, male, middle aged, obesity, prospective studies, sympathetic nervous system
Recommended Citation
Wofford, M. R.; Anderson, Douglas C.; Brown, C. A.; Jones, D. W.; Miller, M. E.; and Hall, J. E., "Antihypertensive Effect of Alpha- and Beta-Adrenergic Blockade in Obese and Lean Hypertensive Subjects" (2001). Pharmacy Practice Faculty Publications. 156.
https://digitalcommons.cedarville.edu/pharmacy_practice_publications/156
