Ovdienko T. Peculiarities of beta-blockers effects on blood pressure daily fluctuations and its response to physical and mental stress in patients with essential hypertension

The dissertation has solved an actual problem of optimization of the beta-blockers use for treatment of essential hypertension on the basis of evaluation of their effects on blood pressure (BP) daily fluctuations, heart rate variability, BP response to physical and mental stress. There have been obtained new data which prove that betaxolol, carvidelol and celiprolol therapy decreases BP level during the day without changing the daily BP rhythm. It has been discovered for the first time that carvidelol therapy has differential effects on the BP level depending on the BP daily rhythm. It has been proved that increase of carvidelol daily dose from 50mg to 100mg makes its antihypertensive efficiency significantly higher. It has been demonstrated that antihypertensive effect of the investigated beta-blockers is characterized by the higher level of SBP decrease in situations of stress than at rest. It has been shown for the first time that carvidelol, betaxolol, celiprolol efficiently prevent hypertensive response to mental stress. It has been found out that BP level defines the type of left ventricle remodeling in situations of stress more than at rest. It has been discovered that heart rate decrease under the influence of beta-blockers is more significant in daily time than at night. It has been found out for the first time out that betaxolol and carvidelol therapy doesn't significantly change general heart rate variability while celiprolol decreases it. There have been found positive and negative characteristics of celiprolol in the therapy of patients with essential hypertension.