[Evaluation of the effectiveness of the long-term treatment of hypertension patients. I. Changes in hemodynamics and myocardial function].

Altogether 106 patients with stage II essential hypertension (EH) were treated for a long time (up to 3 years) with beta-blockers belonging to different classes. In some cases beta-blockers were administered in combination with vasodilators and/or a diuretic. In 66 patients, prolonged continuous treatment led to an appreciable drop in blood pressure (BP) due to the reduction of both the cardiac index and the total peripheral vascular resistance (TPVR), particularly in patients with stage IIB essential hypertension treated with a cardioselective beta-blocker tenormine or an alpha- and beta-blocker trandate. These patients showed a significant decrease in intramyocardial tension, in the thickness of the walls and mass of the myocardium. Regression of left ventricle hypertrophy depended not only on the hemodynamic factors that determine the decrease in the load of the myocardium by the volume or pressure but also on the neurohumoral effects (mainly due to the reduced adrenergic stimulation during treatment with beta-blockers). In 40 patients with stage IIB EH treated occasionally, BP appeared to approach the initial level after 2.5-3 years. Furthermore, these patients manifested an increase in the TPVR. The myocardial mass significantly rose, mainly at the expense of the thickening of the ventricular septum.