Preserved Renal Perfusion During Treatment of Essential Hypertension with the Beta Blocker Nadolol

Abstract

Several beta-adrenergic antagonists impair renal perfusion during treatment of hypertension in man. The acute and chronic effects of a new noncardioselective beta blocker, nadolol, on renal hemodynamics, intravascular volume, and renal electrolyte excretion were studied in 10 men with essential hypertension. Oral nadolol normalized systemic blood pressure without impairment of glomerular filtration rate or renal blood flow, indicating preserved renal blood flow and glomerular filtration rate autoregulation. Intravascular volume and renal excretion of electrolytes were similarly unaltered. Once-daily nadolol lowers blood pressure without renal hemodynamic of functional embarrassment.

Nadolol in essential hypertension: effect on ambulatory blood pressure, renal haemodynamics and cardiac function.

“…Accordingly, the fraction of c put reaching the renal circulation s increased during treatment with nad( over, glomerular filtration rate, urin urinary sodium excretion and bo remained stable. Our findings confir O'Connor et al (1982) who also demonstrated preserved renal perfusion during treatment of essential hypertension with nadolol and the observation of Textor et al (1982) Warren et al, 1981), does not suppress the renal production of vasodilatory kinins, which could have protected against a decrease in renal blood flow. It has also been suggested that nadolol might have dopaminergic properties (Epstein & Oster, 1982).…”

“…After chronic administration of nadolol to patients with essential hypertension, either an increase (Britton etal., 1981;Danesh & Brunton, 1981), a decrease (O'Callaghan et al, 1983), or no change of renal blood flow (O'Connor et al, 1982;Textor et al, 1982;Waal-Manning & Hobson, 1980) have been reported.…”

Early Alteration in Glomerular Reserve in Humans at Genetic Risk of Essential Hypertension

“…After an initial intravenous bolus of 1.4 g inulin, a continuous infusion of inulin was started at 1 mL/min (1 g/100 mL in half-normal saline; ie, 10 mg/min) for 180 minutes. 17 One hour after the start of the inulin infusion, the subjects voided and urine was discarded, before the baseline clearance period. In the next 30-minute (baseline) period, blood was drawn for measurement of blood urea nitrogen, creatinine, electrolytes, lithium, amino acids, inulin, glucose, and insulin, and a timed urine test was collected for measurement of creatinine, electrolytes, lithium, inulin, nitrate/nitrite (as an index of NO production), and cGMP.…”

“…Inulin was measured according to the alkali-stable spectrophotometric method, as we previously described. 17 Urinary cGMP was measured with radioimmunoassay (DuPont-New England Nuclear). To measure urinary nitrate/nitrite (NO x ), nitrate (NO 3 ) was first converted to nitrite (NO 2 ) with Escherichia coli nitrate reductase in vitro 18 ; nitrite was then measured with the Griess spectrophotometric reaction (monitoring absorbance at 546 nm).…”

Effect of nadolol on liver haemodynamics and function in patients with cirrhosis.

“…Similar results were obtained with propranolol treatment Westaby et al, 1984), not surprisingly, since both drugs share the same pharmacological activity and site of action. In the present and in the previous studies we used a dose of nadolol ranging from 40 to 160 mg day-1, as it is commonly administered to patients with arterial hypertension (O'Connor et al, 1982). The between patients differences are likely to depend on baseline adrenergic tone of the patients, and not on liver function, since the drug does not undergo a significant hepatic metabolism.…”