The Hemodynamic Effects of Dilevalol in Patients with Mild Hypertension

The purpose of this study was to determine the hemodynamic mechanism of systemic arterial blood pressure (BP) reduction by dilevalol, a drug with β-adrenoceptor blocking and β2-agonist (vasodilator) properties. Hemodynamic measurements were obtained via placement of a Swan-Ganz thermodilution catheter into the pulmonary artery and via arm cuff BP readings in eight men (mean age. 43 ± 11 years; range, 29–59 years) with uncomplicated hypertension (mean diastolic BP, 95 ± 4 mm Hg). Resting and maximal supine arm exercise hemodynamics were obtained under the following conditions: after a 3 week placebo washout period (BL). 2 h after the first 400 mg single dose (q.d.), and after 2 weeks of therapy with dilevalol 400 mg twice daily (b.i.d.). Parameters recorded were mean arterial pressure (MAP), heart rate (HR), systemic vascular resistance (SVR), stroke volume (SV), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP). Treatment with dilevalol decreased resting MAP and SVR but did not alter CO. During exercise, dilevalol decreased MAP and attenuated exercise-induced increases in CO due to blunting of the HR response. PCWP was significantly increased during exercise with a concomitant increase in SV after b.i.d. but not q.d. dosage. Thus, unlike pure β-blockers, the antihypertensive effects of dilevalol at rest are primarily related to the vasodilatory (β2-agonist) properties. During exercise, the β-adrenoceptor blocking properties predominated.