[Effects of ketanserin on arterial pressure at rest and during physical exercise in essential arterial hypertension]. / Effetti della ketanserina sulla pressione arteriosa a riposo e durante esercizio fisico nell'ipertensione arteriosa essenziale.

ABSTRACT

The antihypertensive effect of ketanserin, a recent 5-hydroxytryptamine (5-HT) antagonist, which acts on the 5-HT2-subtype receptor, was evaluated in 10 patients of both sexes (age range 35-69 years) with mild to moderate essential hypertension. Blood pressure and heart rate were measured at rest, in supine and standing position at the end of two weeks of placebo washout and after 2, 4 and 8 weeks of treatment with ketanserin 20 mg twice daily as monotherapy, while the changes of blood pressure and heart rate during static (hand-grip) and dynamic (bicycle ergometer) exercise were evaluated at the end of placebo and of the fourth week of therapy. The treatment induced a highly significant reduction of supine and standing systolic and diastolic blood pressure during rest, without any significant change in heart rate. During dynamic exercise, the increase in systolic and diastolic blood pressure and heart rate was not blunted by ketanserin, while the drug reduced systolic blood pressure and heart rate increase, during static exercise, with no change of diastolic blood pressure. From these data it may be concluded that ketanserin lowers blood pressure in essential hypertension without any interference with cardiovascular reflexes related to standing or dynamic exercise, and reduces the increase of systolic blood pressure and heart rate during static exercise with favourable interference on myocardial oxygen consumption. This sparing effect on myocardial oxygen demand is particularly relevant in hypertensive patients with asymptomatic coronary disease engaged in normal daily physical activity which includes many forms of static exercise.