A complex study of changes of hemodynamics and myocardial performance was conducted while treating 215 hypertensive patients with obsidan (propranolol), corgard, a cardioselective beta-blocker tenormine and alpha- and beta-blocker trandate. Different hypotensive efficiency and varying hemodynamic mechanisms of its action were found. Obsidan and corgard were mainly efficient in moderate hypertension and marked hypersympathicotonia. Tenormine and trandate produce the most marked hypotensive effect (due to reduction in the vascular tone). The signs of increase in venous blood return to the heart during trandate and obsidan therapy and decrease in venous return after long-term tenormine therapy were established. Myocardial contractility indices decreased after obsidan therapy to the more extent than after corgard and tenormine, and they did not change after trandate. The possibility of myocardial hypertrophy regression was shown (especially in the long-term treatment with tenormine and trandate). A reduction in intramyocardial tension has been stated to depend mainly on hemodynamic factors (reduction in volume or pressure overload on the myocardium) whereas the diminution of the myocardial mass also depends on neurohumoral effects.
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