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Different effects of tocolytic medication on blood pressure and blood pressure amplification

Isabelle Fabry UGent, Peter De Paepe UGent, Jan Kips UGent, SEBASTIAN VERMEERSCH UGent and Lucas Van Bortel UGent (2011) EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY. 67(1). p.11-17
abstract
Background The importance of tocolysis has been discussed extensively. Beta-2 adrenoceptor agonistic drugs like ritodrine have been the reference tocolytic drugs in most countries. Cardiovascular side-effects are frequent. Atosiban, a newer tocolytic drug, is a competitive antagonist of oxytocin and has fewer cardiovascular side effects. Although large studies exist, there is mainly subjective reporting of adverse reactions with a focus on blood pressure data. Objectives Evaluation of the acute effects of therapeutic doses of ritodrine and atosiban in comparison to placebo on central and peripheral blood pressures, central-to-peripheral blood pressure amplification and the augmentation index (AIx) in healthy non-pregnant female volunteers. Methods A double-blind, randomized, crossover trial was carried out in 20 healthy non-pregnant female volunteers. Hemodynamic measurements were performed under standardized conditions. Results At steady state, central and peripheral pressures did not differ from placebo in the atosiban group. During ritodrine-infusion, central SBP increased by 11% versus placebo (p = 0.012) and peripheral SBP by 10% (p = 0.004). In contrast to atosiban and placebo, blood pressure amplification was absent in the ritodrine group. While the AIx did not change in the atosiban group, with ritodrine, the AIx tended to decrease. Conclusions The present study shows the significant effects of ritodrine on the cardiovascular system. Atosiban has no significant effects and may be an appropriate alternative to tocolyticum, particularly in cardiovascularly complicated pregnancies.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
PULSE PRESSURE, NONINVASIVE DETERMINATION, AORTIC PRESSURE, ARTERIAL STIFFNESS, PRETERM LABOR, OXYTOCIN ANTAGONIST ATOSIBAN, Central blood pressure, Hemodynamics, Tocolytic drugs, Atosiban, Ritodrine, AUGMENTATION INDEX, WAVE REFLECTION, BETA-AGONISTS, DOUBLE-BLIND
journal title
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY
Eur. J. Clin. Pharmacol.
volume
67
issue
1
pages
11 - 17
Web of Science type
Article
Web of Science id
000286881600002
JCR category
PHARMACOLOGY & PHARMACY
JCR impact factor
2.845 (2011)
JCR rank
91/259 (2011)
JCR quartile
2 (2011)
ISSN
0031-6970
DOI
10.1007/s00228-010-0926-y
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2003357
handle
http://hdl.handle.net/1854/LU-2003357
date created
2012-01-25 16:13:47
date last changed
2012-02-15 12:50:40
@article{2003357,
  abstract     = {Background The importance of tocolysis has been discussed extensively. Beta-2 adrenoceptor agonistic drugs like ritodrine have been the reference tocolytic drugs in most countries. Cardiovascular side-effects are frequent. Atosiban, a newer tocolytic drug, is a competitive antagonist of oxytocin and has fewer cardiovascular side effects. Although large studies exist, there is mainly subjective reporting of adverse reactions with a focus on blood pressure data. 
Objectives Evaluation of the acute effects of therapeutic doses of ritodrine and atosiban in comparison to placebo on central and peripheral blood pressures, central-to-peripheral blood pressure amplification and the augmentation index (AIx) in healthy non-pregnant female volunteers. 
Methods A double-blind, randomized, crossover trial was carried out in 20 healthy non-pregnant female volunteers. Hemodynamic measurements were performed under standardized conditions. 
Results At steady state, central and peripheral pressures did not differ from placebo in the atosiban group. During ritodrine-infusion, central SBP increased by 11\% versus placebo (p = 0.012) and peripheral SBP by 10\% (p = 0.004). In contrast to atosiban and placebo, blood pressure amplification was absent in the ritodrine group. While the AIx did not change in the atosiban group, with ritodrine, the AIx tended to decrease. 
Conclusions The present study shows the significant effects of ritodrine on the cardiovascular system. Atosiban has no significant effects and may be an appropriate alternative to tocolyticum, particularly in cardiovascularly complicated pregnancies.},
  author       = {Fabry, Isabelle and De Paepe, Peter and Kips, Jan and VERMEERSCH, SEBASTIAN and Van Bortel, Lucas},
  issn         = {0031-6970},
  journal      = {EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY},
  keyword      = {PULSE PRESSURE,NONINVASIVE DETERMINATION,AORTIC PRESSURE,ARTERIAL STIFFNESS,PRETERM LABOR,OXYTOCIN ANTAGONIST ATOSIBAN,Central blood pressure,Hemodynamics,Tocolytic drugs,Atosiban,Ritodrine,AUGMENTATION INDEX,WAVE REFLECTION,BETA-AGONISTS,DOUBLE-BLIND},
  language     = {eng},
  number       = {1},
  pages        = {11--17},
  title        = {Different effects of tocolytic medication on blood pressure and blood pressure amplification},
  url          = {http://dx.doi.org/10.1007/s00228-010-0926-y},
  volume       = {67},
  year         = {2011},
}

Chicago
FABRY, ISABELLE, Peter De Paepe, Jan Kips, SEBASTIAN VERMEERSCH, and Lucas Van Bortel. 2011. “Different Effects of Tocolytic Medication on Blood Pressure and Blood Pressure Amplification.” European Journal of Clinical Pharmacology 67 (1): 11–17.
APA
FABRY, I., De Paepe, P., Kips, J., VERMEERSCH, S., & Van Bortel, L. (2011). Different effects of tocolytic medication on blood pressure and blood pressure amplification. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 67(1), 11–17.
Vancouver
1.
FABRY I, De Paepe P, Kips J, VERMEERSCH S, Van Bortel L. Different effects of tocolytic medication on blood pressure and blood pressure amplification. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY. 2011;67(1):11–7.
MLA
FABRY, ISABELLE, Peter De Paepe, Jan Kips, et al. “Different Effects of Tocolytic Medication on Blood Pressure and Blood Pressure Amplification.” EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY 67.1 (2011): 11–17. Print.