Renin and beta‐adenoceptor blockade‐the mechanism of the hypotensive effect?

Hamer, John

doi:10.1111/j.1365-2125.1976.tb00617.x

Cited by 1 publication

(2 citation statements)

References 22 publications

(14 reference statements)

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“…Although the consensus seems to be that 13-blockers and diuretic drugs, alone or in combination, are an effective form of therapy irrespective of which agents are used (BUhleret al, 1975;Davidson et al, 1976; Dustan et al, 1974;Hamer, 1976;Morgan et al, 1974;Stumpe & Kolloch, 1976), the question of prediction of response remains unsolved. There is no simple clinical analysis to predict a patient's response to either a 13-blocking drug or diuretic.…”

Section: Introductionmentioning

confidence: 99%

“…concluded that in the patients studied, sympathetic nervous system activity mainly determined PRAs as well as antihypertensive efficacy of the P-blocking drugs. These short-term studies (up to 4 weeks) cannot be used to indicate a failure of P-blockade to produce a slow hypotensive response by a mechanism other than suppression of PRA (Hamer, 1976 …”

Section: Introductionmentioning

confidence: 99%

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Diuretics, beta‐blockers or both as treatment for essential hypertension.

Stumpe¹,

Overlack²

1979

Brit J Clinical Pharma

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1 Patients with borderline (group I) and sustained hypertension (group II) were treated with 3-blocking drugs, diuretics and the combination of both. In the two groups of patients the antihypertensive effectiveness of both short-term intravenous or chronically oral propranolol was directly related to the extent to which the drug produced an absolute reduction in plasma renin activity (PRA). No such a correlation could be obtained with pindolol. In group I following ,B-blockade, day-night profiles of PRA were similar to those observed in group II before treatment. Thus, in this latter subgroup, low renin profiles might reflect reduced ,3-adrenergic activity. 2 When the chronically 13-blockaded patients were changed to chronic diuretic therapy it became evident that young hypertensive patients of group II showed a more pronounced BP response than the patients of group I. In those patients of group II in whom pressure was not controlled by the diuretic alone, combination with a 13-blocker led to pressure normalization. 3 The 13-blocking drug induced reduction in pressure was greater in the 25-35 yr olds, than in those older than 55. In contrast, the antihypertensive effect of the diuretic was more pronounced in the 55-70 yr olds than in those younger than 40. 4 It is concluded that sympathetic nervous system activity mainly determined PRA as well as antihypertensive effectiveness of both the P-blockers and the diuretics. As to outpatient management it is proposed that with the exception of young borderline hypertensives who seem to respond best to 13-blockers, initial antihypertensive drug therapy may consist of a diuretic agent. If the antihypertensive effect of the diuretic is insufficient, combination with a P-blocking drug could be used to achieve the best effect.

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