caa a22 4500 477072356 CHVBK 20180405111429.0 cr unu---uuuuu 170330e19960901xx s 000 0 eng 10.1007/BF00051102 doi (NATIONALLICENCE)springer-10.1007/BF00051102 Leenen Frans Hypertension Unit, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada aut 1,4-Dihydropyridines versus beta-blockers for hypertension: Are either safe for the heart? [Elektronische Daten] [Frans Leenen] Summary: Fast-absorbed and short-acting dihydropyridines (e.g., nifedipine capsules) cause intermittent hemodynamic effects associated with sympathetic hyperactivity. In contrast, long-acting dihydropyridines, such as nifedipine GITS and amlodipine, provide, during chronic treatment, stable hemodynamic effects with little or no activation of the sympathetic nervous system. This markedly different pattern of hemodynamic changes may explain why the short-acting drugs cause little to no regression of left ventricular hypertrophy, may make angina worse, and may negatively affect cardiac outcome, whereas the long-acting drugs decrease LV mass as anticipated from the fall in blood pressure and, at least in stable coronary artery disease, produce an outcome comparable with beta-blockers. In hypertension, beta-blocker treatment appears to be associated with a short fall in positive outcome, perhaps in part related to increased rates of sudden death. Such an adverse outcome may also be due to sympathetic hyperactivity, possibly during treatment via cardiac alpha-receptors, but also during the common short periods of noncompliance due to actual increased sympathetic responses. For both drug classes, we suggest that long-acting agents be considered, providing therapeutic coverage well beyond the normal dosing interval. Kluwer Academic Publishers, 1996 coronary artery disease nationallicence left ventricular hypertrophy nationallicence sympathetic activity nationallicence outcome nationallicence Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/4(1996-09-01), 397-402 0920-3206 10:4<397 1996 10 10557 https://doi.org/10.1007/BF00051102 text/html Onlinezugriff via DOI 1 editorial jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00051102 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Leenen Frans Hypertension Unit, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/4(1996-09-01), 397-402 0920-3206 10:4<397 1996 10 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer