Effect Of Metoprolol Tartrate And Heart Rate On Central Aortic Systolic Pressure In Primary Hypertensive Patients

Objective:1. Explore the impact of Metoprolol Tartrate on the central artery systolic pressure(CASP) in primary hypertensive patients and normotensive patients; 2. To investigate the impact of different antihypertensive drug classes and heart rate on central artery systolic pressure in primary hypertensive patients.Methods: 1. The drug test study recruited 86 subjects(46 primary hypertensive patients and 40 normotensive subjects). Brachial arterial pressure, heart rate,central arterial pressure were measured in rest and 30 minutes after the use of 25 mg Metoprolol Tartrate. Data changes before and after the drug use were compared.2.The patients were devided into different monotherapy groups and drug combination groups, and heart rate(HR),CASP and the differerce between brachial systolic blood pressure and CASP(SBP-CASP) were compared between groups.3. According to the HR, 371 subjects were divided into four groups averagely, and PR, CASP and SBP-CASP were compared between groups.Results: 1.30 minutes after the use of Metoprolol Tartrate, HR,systolic blood pressure(SBP) and CASP decreased in the primary hypertensive patients,SBP-CASP decreased at the same time(9.55±4.47 vs 7.60±3.85 mm Hg, P<0.05).The normotensive subjects had the same trend.2.HR and SBP-CASP were similar between the calcium channel blocker group,the renin-angiotensin-system inhibitor group and the beta-blocker group(HR:74.39±10.70,72.95±10.41 and 71.08±8.90 beat per minute,P>0.05,SBP-CASP:9.21 ± 5.58,10.29 ± 4.19 and 8.38 ± 3.59mm Hg,P>0.05).HR and SBP-CASP were similar between the beta-blocker Combination group and the other group(HR:71.45±11.19 vs 71.56±9.66 beat per minute,P>0.05,SBP-CASP: 8.92±4.66 vs 8.97±3.05 mm Hg,P>0.05).3.SBP-CASP in the ≤64 beat per minute(bpm) group,the 65-72 bpm group,the 73-80 bpm group and the ≥81 bpm group were 7.07±2.97 mm Hg,6.94±3.05 mm Hg,8.74±3.40 mm Hg and 11.94 ± 5.40 mm Hg.SBP-CASP were inceasing with HR faster(P<0.05).No significant difference was found between the ≤64 bpm group and the 65-72 bpm group.4. SBP-CASP are correlated with HR and height.SBP-CASP decreases with 0.176 mm Hg with 1 bpm drop in heart rate. SBP-CASP increases with 0.184 mm Hg with 1 cm increase in height.Conclusions:1.The use of Metoprolol Tartrate can quickly reduce the brachial arterial pressure, heart rate,central arterial pressure in primary hypertensive patients,but with the drop of heart rate, the differerce between brachial systolic blood pressure and central artery systolic pressure decreases.2.It is the heart rate that affects the differerce between brachial systolic blood pressure and central artery systolic pressure, rather than the drug itself. when the heart rate is less than 72 bpm, the differerce between brachial systolic blood pressure and central artery systolic pressure is smaller and stable.