Prilosec and blood pressure
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Prilosec and Blood Pressure: Insights from Research on Prizidilol
Introduction to Prizidilol and Its Antihypertensive Effects
Prizidilol, also known as SKF 92657, is a novel antihypertensive medication that combines precapillary vasodilator and non-selective beta-adrenoceptor-blocking actions. Research has extensively studied its effects on blood pressure, heart rate, and other cardiovascular parameters in patients with essential hypertension.
Blood Pressure Reduction with Prizidilol
Multiple studies have demonstrated that Prizidilol effectively reduces both systolic and diastolic blood pressure in patients with essential hypertension. In a study involving ten patients, a significant reduction in both systolic and diastolic blood pressure was observed after four weeks of treatment with Prizidilol1. Another study with 24 patients confirmed these findings, showing a reduction in blood pressure 24-27 hours after drug intake, particularly with doses ranging from 400 to 800 mg per day3 5.
Mechanism of Action: Vasodilation and Beta-Adrenoceptor Blocking
The antihypertensive effect of Prizidilol is primarily attributed to its ability to induce peripheral vasodilation. This mechanism was supported by an increase in the cardiac index observed after four weeks of treatment1. Additionally, Prizidilol's beta-adrenoceptor blocking action contributes to its efficacy in lowering blood pressure without significantly altering heart rate in most cases2 4.
Impact on Heart Rate and Sympathetic Nervous System
While Prizidilol effectively reduces blood pressure, its impact on heart rate varies. In some studies, a slight but significant decrease in heart rate was noted after moderate doses3 5. However, other research indicated no significant changes in heart rate, suggesting that the drug's effect on heart rate may depend on the dosage and individual patient response2 4.
Plasma Volume and Renal Function
Prizidilol treatment has been associated with an increase in plasma volume, although this did not lead to significant changes in body weight in most patients1 2. However, some patients did develop edema, necessitating the addition of diuretics in certain cases2. Additionally, a slight decrease in glomerular filtration rate was observed, indicating a potential impact on renal function that warrants further investigation2.
Tolerability and Side Effects
Prizidilol is generally well-tolerated, but some patients have reported side effects such as dizziness, tiredness, and edema3 5. These side effects were relatively mild and did not significantly impact the overall tolerability of the drug.
Conclusion
Prizidilol shows promise as an effective antihypertensive medication, capable of significantly reducing both systolic and diastolic blood pressure through its combined vasodilator and beta-adrenoceptor blocking actions. While it is generally well-tolerated, some patients may experience side effects such as dizziness and edema. Further research is needed to fully understand its long-term impact on renal function and to optimize dosing strategies for individual patients.
Sources and full results
Most relevant research papers on this topic
Effects of prizidilol (SKF 92657) on blood pressure, haemodynamics, sympathetic nervous system activity and plasma volume in essential hypertension.
PrizIDILOL significantly reduces blood pressure and improves cardiac performance in essential hypertensive patients, due to peripheral vasodilation and increased sympathetic nervous system activity.
Non-RCTChanges in blood pressure, fluid volumes and glomerular filtration rate during long-term treatment with prizidilol, an antihypertensive drug with combined vasodilatator and beta-adrenoceptor blocking actions.
Prizidilol effectively reduces blood pressure and glomerular filtration rate in patients with essential hypertension, but may cause oedema and weight gain.
RCTPrizidilol (SKF 92657) in primary hypertension.
Prizidilol effectively reduces blood pressure in patients with essential hypertension, with well-tolerated side effects.
RCTAntihypertensive Effect of Prizidilol
Prizidilol effectively reduces blood pressure when given twice daily (400 mg 2), but once daily doses do not show a significant reduction in blood pressure.
RCTPrizidilol (SKF 92 657) in primary hypertension
Prizidilol effectively reduces blood pressure in primary hypertension patients, with well-tolerated side effects, but may cause dizziness and fatigue.
RCTPRINDOLOL IN HYPERTENSION
Prindolol effectively controlled the patient's blood pressure, but her depression led to a suicide attempt.
Case ReportAcute effects of prizidilol on blood pressure, heart rate, catecholamines, renin and aldosterone in essential hypertension
Prizidilol is a potent antihypertensive agent with early dominance of beta-blockade followed by concomitant vasodilator properties in patients with essential hypertension.
RCTNSAIDs and Increased Blood Pressure
NSAID use can significantly increase blood pressure, with piroxicam, naproxen, and indomethacin having the greatest pressor effect, and excessive use may increase the risk of hypertension and stroke.
Meta-Analysis
Highly Cited[The effect of prindolol on the blood-pressure profile of hypertensives (with special consideration of response to exercise and plasma-renin activity) (author's transl)].
Prindolol effectively lowers blood pressure in patients with essential hypertension, especially reducing hypertensive reactions to daily physical exercise.
Non-RCTPrizidilol, an antihypertensive with precapillary vasodilator and β‐adrenoceptor blocking actions, in primary hypertension
Prizidilol effectively reduces blood pressure in primary hypertension patients, with greater effects in slow acetylators.
Non-RCT