Nicardipine and propranolol in the treatment of hypertension: Similar antihypertensive but dissimilar hemodynamic actions

Although the precise cause of essential hypertension is not known, empiric treatment is indicated to reduce cardiovascular risks. Several pharmacologic classes of antihypertensive drugs are available to reduce blood pressure, but they do so by different hemodynamic mechanisms. The physiologic therapeutic goal in patients with hypertension is to normalize the systemic vascular resistance without inducing major alterations in the cardiac output. In this study we compared the antihypertensive and hemodynamic actions of nicardipine, a calcium antagonist, with propranolol, a β-blocking drug. Both drugs were effective in the treatment of hypertension. However, while propranolol therapy decreased the resting and exercise left ventricular ejection fraction and cardiac output, cardiac function was well preserved during nicardipine therapy. It is concluded that both nicardipine and propranolol exert similar antihypertensive actions but that they cause dissimilar hemodynamic consequences in patients with uncomplicated hypertension.