From the Guidelines
Beta-blockers increase vascular peripheral resistance, increase blood pressure, and decrease heart rate.
Mechanism of Action
- Beta-blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline, and by slowing the heart rate and reducing its workload 1.
- After beta-adrenergic blockade, heart rate and cardiac output decrease, whereas peripheral resistance increases 1.
Alternative Medications
- Other medications such as bevacizumab, sorafenib, and sunitinib can also increase blood pressure by reducing the formation of nitric oxide in the walls of resistance vessels, leading to vasoconstriction and increased peripheral resistance 1.
- These medications can cause increases in systemic arterial pressure, with reported incidence ranging from 5% to 43% 1.
Clinical Considerations
- The use of these medications should be carefully considered in patients with pre-existing hypertension or cardiovascular disease.
- Monitoring of blood pressure and cardiovascular function is essential when using these medications 1.
From the Research
Medication Effects on Vascular Peripheral Resistance, Blood Pressure, and Heart Rate
The medication that increases vascular peripheral resistance, increases blood pressure, and decreases heart rate is not explicitly stated in the provided studies. However, some studies provide information on the effects of certain medications on these parameters:
- Beta blockers without strong intrinsic sympathomimetic activity reduce heart rate and cardiac output immediately, but due to a reflex increase in total peripheral resistance index, blood pressure is unchanged or only slightly reduced 2.
- Alpha-adrenergic receptor blockers, such as prazosin, doxazosin, and trimazosin, reduce blood pressure via a reduction in total peripheral resistance index without reflex tachycardia 2.
- The α1-adrenoceptor agonist phenylephrine (PE) has pure vasoconstrictive properties and increases vascular peripheral resistance, blood pressure, and decreases heart rate due to a strong reflex-decrease in cardiac output 3.
- Urapidil, a peripheral postsynaptic alpha 1-adrenoceptor antagonist with central agonistic action at serotonin 5-HT1A receptors, reduces blood pressure by decreasing peripheral vascular resistance without altering heart rate 4.
Key Findings
- The effects of beta blockers on vascular peripheral resistance and blood pressure are complex and depend on the specific type of beta blocker and its intrinsic sympathomimetic activity 2, 5.
- Alpha-adrenergic receptor blockers and urapidil reduce blood pressure by decreasing vascular peripheral resistance 2, 4.
- Phenylephrine increases vascular peripheral resistance and blood pressure, and decreases heart rate due to a strong reflex-decrease in cardiac output 3.