Antihypertensive drugs in combination: Effects of methyldopa on thiazide-induced changes in renal hemodynamics and plasma renin activity

1975 ◽  
Vol 135 (5) ◽  
pp. 660-663 ◽  
Author(s):  
N. M. Kaplan
1975 ◽  
Vol 13 (26) ◽  
pp. 101-103

Thiazide diuretics such as bendrofluazide and chlorothiazide have been used for nearly 20 years in the treatment of hypertension. They have been regarded as rather weak antihypertensive agents which could be used alone only in mild hypertension and otherwise as adjuvants to more potent drugs in more serious cases.1 There are however some patients with ‘essential’ hypertension who are very sensitive to diuretics and in whom the pressure may be brought down to normal by a thiazide2 or spironolactone3 even when it is initially considerably raised. Furthermore a few patients who are responsive to thiazides are strikingly unresponsive to non-diuretic antihypertensive drugs. Patients particularly likely to respond to a thiazide diuretic4 or spironolactone3 commonly have low plasma renin activity and this occurs in about 25% of patients with essential hypertension.5 Since plasma renin activity is not routinely estimated it is simplest to identify these patients by observing the response to an adequate trial of a thiazide.


1986 ◽  
Vol 250 (1) ◽  
pp. F40-F46 ◽  
Author(s):  
S. Simchon ◽  
R. Y. Chen ◽  
R. D. Carlin ◽  
F. C. Fan ◽  
K. M. Jan ◽  
...  

The effects of alterations in apparent blood viscosity on renal hemodynamics and plasma renin activity (PRA) were studied in dogs anesthetized with sodium pentobarbital. Blood viscosity was altered isovolemically either by changes in hematocrit (Hct) or by an increase in plasma viscosity (dextran administration). Arterial blood pressure and renal blood flow (RBF) remained relatively constant when apparent blood viscosity was elevated by changes in Hct or plasma viscosity. Thus the hyperviscosity of blood was associated with a decrease of renal vascular hindrance, resulting in an essentially unchanged renal flow resistance. The decrease in renal vascular hindrance may result from renal vasodilation. In hyperviscosity induced with dextran, the increase in PRA correlates linearly with the decrease in renal vascular hindrance, with a coefficient of correlation of 0.968 (P less than 0.005). The increase in PRA that resulted when Hct was raised from 25 to 55% also can be correlated linearly with the decrease in renal vascular hindrance, with a coefficient of correlation of 0.953 (P less than 0.005). These results suggest that the decrease in renal vascular hindrance in response to a rise in apparent blood viscosity leads to an increase in PRA.


1992 ◽  
Vol 12 (1-2) ◽  
pp. 37-40 ◽  
Author(s):  
Edi Levi ◽  
Oguz K. Baskurt ◽  
Neslihan Dikmenoglu ◽  
Serdar Caglayan ◽  
Rustu Guner ◽  
...  

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