Cardiovascular adaptation to mudpack therapy in hypertensive subjects treated with different antihypertensive drugs

Eur Rev Med Pharmacol Sci. 2014;18(17):2544-50.


Objective: In selected hypertensive subjects, cardiovascular adaptation to warm environments may be inadequate or even harmful: heating associated to mudpack therapy may cause unexpected hypotension. How different antihypertensive drugs may affect the cardiovascular response to mudpack therapy is poorly studied.

Aims: To evaluate the effects of β-blockers and angiotensin II receptor antagonists/ACE inhibitors on the acute cardiovascular adaptation to mudpack treatment in SPA in elderly hypertensive patients.

Patients and methods: Thirty-one elderly subjects were divided in normotensive subjects (N; n=10) and hypertensive patients treated with ACE-inhibitors/Angiotensin II receptor antagonists (HTA; n=12) or with selective β1-blockers (HTB; n=9). Systolic (SBP) and diastolic (DBP) blood pressure were continuously recorded (10 min) in supine position, immediately before and during mudpack treatment (40°C). Heart rate (HR), stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) were assessed.

Results: During mudpack treatment SBP did not significantly change in both HTA and N groups (132±11 and 112±13 mmHg, respectively), but significantly decreased in HTB (111±18 mmHg, p < 0.01 vs baseline) patients. HR increased in all groups (HTA: 72±10 bpm; HTB: 65±6 bpm; N: 70±10 bpm; p < 0.01 vs baseline). A significant reduction (p < 0.01 vs baseline) in SV and CO occurred in HTB, but not in HTA and N groups. TPR significantly increased in HTB (1335±464, p < 0.01 vs baseline) but not in HTA and N subjects (1389±385 and 1245±323, respectively).

Conclusions: Mud treatment did not cause relevant haemodynamic changes in normotensive and HTA-treated hypertensive subjects. Conversely, β-blocking treatment apparently limited the cardiovascular adaptation to thermic stress, through a possible reduction in myocardial contractility, thereby, causing a significant decrease, although not dangerous, in systolic blood pressure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological / drug effects
  • Adrenergic beta-Antagonists / therapeutic use*
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Cardiovascular System / drug effects
  • Cardiovascular System / physiopathology
  • Combined Modality Therapy
  • Complementary Therapies / adverse effects
  • Complementary Therapies / methods
  • Female
  • Heart Rate / drug effects
  • Hemodynamics / drug effects
  • Humans
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Hyperthermia, Induced / adverse effects
  • Hyperthermia, Induced / methods*
  • Male
  • Vascular Resistance


  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents