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Angiology
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Differential Exercise Effects of Captopril and Nadolol in Patients with Essential Hypertension

John B. Kostis

Division of Cardiovascular Diseases & Hypertension, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Daniel M. Shindler

Division of Cardiovascular Diseases & Hypertension, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Abel E. Moreyra

Division of Cardiovascular Diseases & Hypertension, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Michael C. Ruddy

Division of Cardiovascular Diseases & Hypertension, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Stephen Schneider

Division of Cardiovascular Diseases & Hypertension, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

Nora Cosgrove

Division of Cardiovascular Diseases & Hypertension, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ

In a crossover study, 12 patients with mild to moderate hypertension were given placebo, captopril (12.5 to 50 mg three times a day), and nadolol (20 to 160 mg once a day) to control the resting diastolic blood pressure to a nearly identical degree (p < 0.0001) (106.1 ±4 placebo, 89.6 ±8 captopril, 89.8 ±7 nadolol). Both drugs lowered (p < 0.0004) systolic and diastolic blood pressure at rest and during exercise. However, systolic blood pressure lowering during exercise was more pronounced (p < 0.05) with nadolol than with captopril (difference of 6 mmHg, 16 mmHg, and 21 mmHg at 5.0, 7.0, and 9.0 metabolic equivalents (METS) respectively). Heart rate was lower (p < 0.05) at rest and during exercise with nadolol as compared with placebo and with captopril. These data imply different mechanisms of action of the two drugs at rest and during exercise and may help in selection of drug therapy in special patient subsets.

Angiology, Vol. 43, No. 8, 647-652 (1992)
DOI: 10.1177/000331979204300804
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