Abstract
Propranolol (P) can produce myocardial depression, and such an effect would be undesirable and potentially dangerous if it occurred when P is used to treat sustained hypertension in children. This study reports the effects on myocardial function evaluated by echocardiography in 8 hypertensive children (6 to 16 years) treated with P. Six of the pats had essential hypertension, 1 had renovascular hypertension and 1 had renal parenchymal disease. None of the children had clinical evidence of heart failure. P (1.8 to 11 mg/Kg/day) was effective in treating the hypertension in these pats producing significant (p<0.02) reductions in systolic BP (147±5 to 127±4mmHg, X̄±SEM), diastolic BP (97±3 to 82±3mmHg) and heart rate (96±7 to 70±6 bpm). The changes in heart rate and BP produced by P did not alter left ventricular (LV) pre-load since LV end-diastolic dimension remained the same (41±2mm; X̄±SEM). These same doses of P produced no significant alteration of LV function as described by LV shortening fraction (0.40±0.02 vs. 0.38±0.03; pretreatment vs. treatment). LV velocity of shortening (1.54±0.08 vs. 1.48±0.15 muscle lengths/sec) or LV pre-ejection period divided by LV ejection time (0.36±0.02 vs. 0.39±0.04). It is concluded that doses of P which are in the therapeutic range for treating hypertension in children without preexisting heart failure do not produce detectable alteration of left ventricular function.
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Boerth, R., Boucek, R. & Graham, T. PROPRANOLOL IN THE TREATMENT OF HYPERTENSION IN THE YOUNG: LACK OF EFFECT ON MYOCARDIAL FUNCTION. Pediatr Res 11, 386 (1977). https://doi.org/10.1203/00006450-197704000-00100
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DOI: https://doi.org/10.1203/00006450-197704000-00100