BETAXOLOL INFLUENCES SPONTANEOUS CHANGES OF BLOOD-PRESSURE AND ST-SEGMENT DEPRESSIONS IN HYPERTENSIVES WITHOUT CORONARY-ARTERY DISEASE

In 8 hypertensives with anginal pain and angiographically excluded cor onary artery disease simultaneous 24 h Holter- and 24 h ambulant blood pressure monitoring were performed. 11 episodes of significant ST-seg ment depressions of 136 min were found in 5 of 8 patients. Heart rate increased by more than 30 bpm in all cases, whereas only in 7 of 11 ep isodes the systolic blood pressure increased by more than 20 mmHg as c ompared to the measurements 60 min before the ST-segment depressions. After an antihypertensive treatment with the beta-blocker betaxolol th e heart rate, the systolic and diastolic blood pressure decreased sign ificantly, only in 2 of 8 hypertensives 4 ischemic episodes of a total length of 60 min were recorded. Increases of heart rate and myocardia l wall stress seem to be the most important factors which induce myoca rdial ischemia in hypertensives without coronary artery disease, a spe cific therapy should therefore include a reduction of heart rate and s ystolic wall stress.