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Diuretics, beta‐blockers or both as treatment for essential hypertension.
Author(s) -
Stumpe KO,
Overlack O
Publication year - 1979
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1979.tb04690.x
Subject(s) - pindolol , diuretic , medicine , plasma renin activity , propranolol , essential hypertension , blood pressure , beta (programming language) , beta blocker , antihypertensive drug , adrenergic beta antagonists , endocrinology , pharmacology , renin–angiotensin system , heart failure , computer science , programming language
1 Patients with borderline (group I) and sustained hypertension (group II) were treated with beta‐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 beta‐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 beta‐adrenergic activity. 2 When the chronically beta‐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 beta‐blocker led to pressure normalization. 3 The beta‐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 beta‐blockers and the diuretics. As to outpatient management it is proposed that with exception of young borderline hypertensives who seem to respond best to beta‐blockers, initial antihypertensive drug therapy may consist of a diuretic agent. If the antihypertensive effect of the diuretic is insufficient, combination with a beta‐blocking drug could be used to achieve the best effect.