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HYPOTENSIVE EFFECT OF METHYLDOPA IN RENAL FAILURE ASSOCIATED WITH HYPERTENSION
Author(s) -
Stenbæk Ø.,
Myhre E.,
Brodwall E. K.,
Hansen T.
Publication year - 1972
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1972.tb00060.x
Subject(s) - medicine , methyldopa , supine position , renal function , blood pressure , essential hypertension , kidney , cardiology , endocrinology
Increased sensitivity to the hypotensive action of methyldopa is often seen in patients with renal failure. It is generally accepted that the increased sensitivity is due to drug accumulation in renal failure, though there are very few studies on this topic. The hypotensive effect and the serum concentration of unconjugated methyldopa have been determined in 6 patients with advanced renal failure and 7 patients with essential hypertension and normal or slightly reduced renal function. Following i.v. injection of 200 mg methyldopa the maximal decrease of the supine mean BP was on an average 21.5% in patients with renal failure and 11.5% in patients with essential hypertension without renal insufficiency. The maximal response was somewhat delayed in renal failure. The supine, standing and post‐exercise BP was recorded during shorty‐term oral treatment in the two groups of patients. The average reduction of the mean BP in patients with renal failure was 11, 16 and 20%, respectively. In patients with essential hypertension the figures were 16, 26 and 25%, respectively. The slightly higher hypotensive effect in the patients with normal renal function, however, was achieved after an average serum concentration of unconjugated methyldopa amounting to more than 4 times that found in the patients with renal failure. The study demonstrated an augmented sensitivity to the hypotensive effect of methyldopa in renal failure. The high sensitivity to the hypotensive action of the drug was not due to increased serum concentration of unconjugated methyldopa.