Does digoxin lower bp
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The Impact of Digoxin on Blood Pressure: A Comprehensive Review
Digoxin and Blood Pressure Regulation in Hypertensive Models
Role of Endogenous Digoxin-Like Factors in Hypertension
Research has shown that endogenous digoxin-like factors play a significant role in blood pressure (BP) regulation, particularly in certain hypertensive models. In young rats with DOCA-salt and one-kidney, one-clip (1K1C) Goldblatt hypertension, acute blockade of these factors led to a decrease in BP by reducing systemic resistance, although this was partially offset by an increase in cardiac output . This suggests that endogenous digoxin-like factors are crucial in maintaining elevated BP in these specific models of hypertension.
Digoxin's Hemodynamic Effects in Chronic Heart Failure
In patients with chronic congestive heart failure, the combination of digoxin and nifedipine was studied for its acute hemodynamic effects. While nifedipine alone significantly reduced systolic and diastolic BP, the addition of digoxin did not further lower BP. Instead, digoxin primarily improved cardiac output and systemic vascular resistance without a significant impact on BP . This indicates that while digoxin has beneficial effects on heart function, it does not directly lower BP in these patients.
Antihypertensive Effects of Digoxin in Experimental Models
In experimental models, chronic hypertension induced by ouabain was effectively reduced by digoxin. In rats infused with ouabain, which led to elevated BP, subsequent administration of digoxin normalized BP despite continued high levels of circulating ouabain . This suggests that digoxin can counteract the hypertensive effects of ouabain, highlighting its potential antihypertensive properties in specific contexts.
Anti-Digoxin Antiserum and Blood Pressure Reduction
Further evidence of digoxin's role in BP regulation comes from studies using anti-digoxin antiserum. In chronic aortic coarctate hypertensive rats, administration of anti-digoxin antiserum significantly lowered arterial BP, with the effect lasting for about 30 minutes . This supports the hypothesis that endogenous digoxin-like substances are involved in maintaining elevated BP in certain forms of hypertension.
Conclusion
In summary, while digoxin itself does not directly lower BP in all contexts, it plays a complex role in BP regulation through its interaction with endogenous digoxin-like factors and its effects on cardiac function. In specific hypertensive models, such as those induced by ouabain or aortic coarctation, digoxin has demonstrated significant antihypertensive effects. However, in patients with chronic heart failure, its primary benefits are related to improving cardiac output rather than reducing BP. These findings underscore the nuanced role of digoxin in cardiovascular health and its potential therapeutic applications in managing hypertension.
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