本態性高血圧症の血圧日内変動および血行動態に及ぼすβ遮断薬Ｃｅｌｉｐｒｏｌｏｌの影響

Abstract

Celiprolol is a selective β1-antagonist with intrinsic sympathomimetic activity. The effects of celiprolol on 24-hr ambulatory blood pressure during daily activity and its hemodynamic effects at rest were investigated in 11 patients with mild to moderate essential hypertension. Patients were treated with celiprolol 200 mg once a day for 4 to 6 wks, followed by an increased dose of 400 mg for 12 to 14 wks. The 24-hr ambulatory blood pressure was monitored using a portable automatic noninvasive device during the control and treatment periods. For the hemodynamic effect, cardiac output was measured by the dye dilution method during the two periods to calculate total peripheral resistance.(1) As a result, both blood pressure at visit to the hospital and 24-hr ambulatory blood pressure were reduced significantly during the treatment period. Regarding 24-hr ambulatory blood pressure, blood pressure significantly decreased when patients were awake but not when they were asleep.There was no apparent difference between the control and treatment periods in the variability of 24-hr ambulatory blood pressure as expressed by the standard deviation of average values. Heart rate decreased when patients were awake but increased during sleep.(2) Concerning hemodynamic effects, there was significant change in total peripheral resistance but none in cardiac output.Celiprolol reduced blood pressure in the waking state rather than during sleep, and did not obviously affect the variability of 24-hr ambulatory blood pressure. Celiprolol showed hypotensive effects by reducing total peripheral resistance without decreasing cardiac output. Therefore, it can be concluded that celiprolol is a useful antihypertensive drug.