The effects of acute beta-adrenergic blockade on aortic wave reflection in postmenopausal women

Am J Hypertens. 2013 Apr;26(4):503-10. doi: 10.1093/ajh/hps074. Epub 2013 Jan 11.

Abstract

BACKGROUND Acute beta-adrenergic blockade increases aortic-wave reflection in young women. However, it is not known whether this effect extends to postmenopausal women. We therefore examined the effect of systemic beta-adrenergic blockade on aortic wave reflection in 14 postmenopausal women with a mean age of 58±2 years. METHODS Aortic pressure waveforms were synthesized noninvasively from high-fidelity radial pressure waveforms obtained through applanation tonometry before and during systemic beta-blockade with propranolol given in a bolus dose of 0.25mg/kg, followed by a continuous infusion at 0.004mg/kg/min. To further examine the effects of acute beta-blockade on aortic-wave reflection in postmenopausal women, we compared the changes in hemodynamics and indices of aortic-wave reflection with published data from a previous study with a protocol identical to that in the present study but which involved young women. RESULTS Acute beta-blockade increased the aortic augmentation index (AIx) in postmenopausal women (32±2% vs. 35±2%, P < 0.01). However, AIx adjusted for a heart rate of 75 bpm (AIx75) was unchanged (25±2% vs. 24±2%, P > 0.05). The changes in AIx, AIx75, and the amplitude of reflected waves (augmented aortic pressure) during beta-blockade were all substantially smaller in postmenopausal women than in their younger counterparts (P < 0.05). Conclusions As compared with those in our previously published study involving young women, indices of aortic-wave reflection were significantly less affected by acute systemic beta-adrenergic blockade in the postmenopausal women in the present study. Taken together, our data suggest that the negative effects (i.e. increased aortic wave reflection) of nonselective beta-adrenergic blockade are less pronounced in postmenopausal than in young women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Aorta / physiopathology*
  • Blood Pressure / drug effects*
  • Female
  • Humans
  • Middle Aged
  • Postmenopause*
  • Propranolol / therapeutic use*
  • Pulse Wave Analysis
  • Vascular Stiffness / drug effects*

Substances

  • Adrenergic beta-Antagonists
  • Propranolol