Antihypertensive Effect of Spironolactone in Essential, Renal and Mineralocorticoid Hypertension

1973 ◽  
Vol 45 (s1) ◽  
pp. 219s-224s
Author(s):  
F. Mantero ◽  
D. Armanini ◽  
S. Urbani
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Primary Aldosteronism ◽  
Antihypertensive Effect ◽  
Hypotensive Effect ◽  
Arterial Disease ◽  
Renin Activity ◽  
Postural Change ◽  
Adrenal Surgery ◽  
Hypotensive Response

1. The hypotensive effect of spironolactone has been studied in twenty-four patients with various forms of hypertension. 2. In essential hypertension a greater fall of blood pressure was achieved in patients with renin activity hyporesponsive to postural change than in those in whom renin responded normally to posture. 3. A poor hypotensive response was observed in patients with renal or renal arterial disease and secondary aldosteronism. 4. The variable hypotensive response seen in patients with primary aldosteronism predicted the response to adrenal surgery. 5. Blood pressure was not lowered by spironolactone in one case of 17-hydroxylation deficiency or in one case of malignant ovarian arrhenoblastoma producing aldosterone.

Blood Pressure Decrease and Responsiveness to Renin-Releasing Stimuli under Increasing Doses of Propranolol in Patients with Essential Hypertension

1974 ◽  
Vol 48 (s2) ◽  
pp. 77s-79s
Author(s):  
G. Leonetti ◽  
G. Mayer ◽  
A. Morganti ◽  
L. Terzoli ◽  
A. Zanchetti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Moderate Hypertension ◽  
Plasma Renin ◽  
Hypotensive Effect ◽  
Renin Activity ◽  
Hypertensive Patients ◽  
Small Doses ◽  
Oral Doses

1. Stepwise increases of oral doses of propranolol produced both a significant lowering of blood pressure and suppression of plasma renin activity in sixteen patients with mild or moderate normal-renin essential hypertension. 2. The hypotensive and the renin-suppressive actions of propranolol were differently related to plasma propranolol concentrations. At the lowest propranolol concentrations (15–40 nmol/l), there was almost no decrease in blood pressure whereas plasma renin activity and responsiveness to renin-releasing stimuli (standing, intravenous frusemide) were already strongly depressed (greater than 50%). Therefore in a large number of normal-renin hypertensive patients under small doses of propranolol, the renin-suppressive action of the drug can be dissociated from the hypotensive effect. Dissociation of the two effects, though in the opposite way, was also observed in three of four low-renin hypertensive patients, whose blood pressure was decreased by propranolol without further reduction of the already suppressed plasma renin activity. 3. It is concluded that in patients with mild and moderate hypertension and low or normal plasma renin activity, the hypotensive effect of propranolol cannot be attributed to suppression of renin activity. These conclusions do not necessarily apply to high-renin hypertensive patients.

Enhancement of the Antihypertensive Effect of Hydrochlorothiazide in Dogs after Suppression of Renin Release by Beta-Adrenergic Blockade

1975 ◽  
Vol 48 (2) ◽  
pp. 147-151
Author(s):  
C. S. Sweet ◽  
M. Mandradjieff
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Arterial Blood Pressure ◽  
Antihypertensive Effect ◽  
Plasma Renin ◽  
Renin Activity ◽  
Renin Release ◽  
Antihypertensive Activity ◽  
Adrenergic Blockade ◽  
Arterial Blood

1. Renal hypertensive dogs were treated with hydrochlorothiazide (8−2 μmol/kg or 33 μmol/kg daily for 7 days), or timolol (4.6 μmol/kg daily for 4 days), a potent β-adrenergic blocking agent, or combinations of these drugs). Changes in mean arterial blood pressure and plasma renin activity were measured over the treatment period. 2. Neither drug significantly lowered arterial blood pressure when administered alone. Plasma renin activity, which did not change during treatment with timolol, was substantially elevated during treatment with hydrochlorothiazide. 3. When timolol was administered concomitantly with hydrochlorothiazide, plasma renin activity was suppressed and blood pressure was significantly lowered. 4. These observations suggest that compensatory activation of the renin-angiotensin system limits the antihypertensive activity of hydrochlorothiazide in renal hypertensive dogs and suppression of diuretic-induced renin release by timolol unmasks the antihypertensive effect of the diuretic.

Assessment of the Antihypertensive Effect of Atenolol with 24 H Ambulatory Monitoring of Blood Pressure

1979 ◽  
Vol 57 (s5) ◽  
pp. 387s-389s ◽  
Author(s):  
J. S. Floras ◽  
P. Fox ◽  
M. O. Hassan ◽  
J. V. Jones ◽  
P. Sleight ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Arterial Blood Pressure ◽  
Antihypertensive Effect ◽  
Ambulatory Monitoring ◽  
Single Daily Dose ◽  
Pressure Measurements ◽  
Arterial Blood ◽  
Blood Pressure Study ◽  
Daily Dose

1. Twenty-four hour intra-arterial blood pressure measurements and electrocardiograms were obtained from 12 subjects with untreated essential hypertension. 2. The patients kept records of their activity, paying particular attention to times of retiring to bed, and times of waking in the morning. 3. All subjects were treated with a single daily dose of atenolol (50 to 200 mg) for between 2 and 9 months, and then underwent a second 24 h blood pressure study. 4. Arterial blood pressure was lowered significantly throughout the 24 h period with a single daily dose of atenolol.

The effectiveness of differentiated treatment of patients with essential hypertension

1982 ◽  
Vol 63 (2) ◽  
pp. 19-21
Author(s):  
Yu. A. Panfilov ◽  
N. N. Kryukov ◽  
E. D. Baibursyan
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Beta Blocker ◽  
Hypotensive Effect ◽  
Blood System ◽  
Differential Treatment ◽  
Hypertensive Patients ◽  
Bed Days

Abstract. Depending on the hemodynamic type and state of the kallikreinkinin 'blood system, differential treatment of 246 hypertensive patients was carried out using the beta-blocker anaprilin and the peripheral arteriolar vasodilator apressin. A pronounced hypotensive effect was observed in 82.5% of patients. In patients who underwent differential treatment, a decrease in blood pressure was observed 3.2 days earlier than in patients who were treated empirically; hospitalization terms were reduced by an average of 2.5 bed-days.

Solitary Kidney and Ageing as Causes of Low Renin and Aldosterone Concentrations: Relevance to ‘Low-Renin’ Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 177s-180s ◽  
Author(s):  
R. Gordon ◽  
Freda Doran ◽  
M. Thomas ◽  
Frances Thomas ◽  
P. Cheras
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Normotensive Subjects ◽  
The Mean

1. As experimental models of reduced nephron population in man, (a) twelve men aged 15–32 years who had one kidney removed 1–13 years previously and (b) fourteen normotensive men aged 70–90 years were studied. Results were compared with those in eighteen normotensive men aged 18–28 years and eleven men aged 19–33 years with essential hypertension. 2. While the subjects followed a routine of normal diet and daily activity, measurements were made, after overnight recumbency and in the fasting state, of plasma volume and renin activity on one occasion in hospital and of blood pressure on five to fourteen occasions in the home. Blood pressure was also measured after standing for 2 min and plasma renin activity after 1 h standing, sitting or walking. Twenty-four hour urinary aldosterone excretion was also measured. 3. The measurements were repeated in the normotensive subjects and subjects in (a) and (b) above after 10 days of sodium-restricted diet (40 mmol of sodium/day). 4. The mean plasma renin activity (recumbent) in essential hypertensive subjects was higher than in normotensive subjects. In subjects of (a) and (b) above, it was lower than normotensive subjects, and was not increased by dietary sodium restriction in subjects of (a). 5. The mean aldosterone excretion level was lower in old normotensive subjects than in the other groups, and increased in each group after dietary sodium restriction. 6. Mean plasma volume/surface area was not different between the four groups and in normotensive, essential hypertensive and nephrectomized subjects but not subjects aged 70–90 years was negatively correlated with standing diastolic blood pressure.

Effect of Atenolol(Tenormin®) on Blood Pressure and Plasma Renin Activity in Essential Hypertension

1982 ◽  
Vol 12 (1) ◽  
pp. 145
Author(s):  
Soon Kyu Suh ◽  
Sae Wha Yoo ◽  
Soon Chang Park ◽  
Joon Sock Kim ◽  
Kyung Ho Kang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity

Effects of Indomethacin Alone and during Diuretic or β-Adrenoreceptor-Blockade Therapy on Blood Pressure and the Renin System in Essential Hypertension

1978 ◽  
Vol 55 (s4) ◽  
pp. 203s-205s ◽  
Author(s):  
J. A. Lopez-Ovejero ◽  
M. A. Weber ◽  
J. I. M. Drayer ◽  
J. E. Sealey ◽  
J. H. Laragh
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Water Retention ◽  
Antihypertensive Effect ◽  
Renin Secretion ◽  
Blood Pressure Lowering ◽  
Blood Pressure Lowering Effect ◽  
Uncomplicated Hypertension ◽  
Pressure Lowering ◽  
Propranolol Therapy

1. Indomethacin was administered alone or in addition to either diuretic or propranolol therapy to three groups of patients with essential hypertension on a free sodium diet. 2. Indomethacin administration reduced renin secretion by about 30% in untreated uncomplicated hypertensive patients and by about 75% in those whose renin secretion had either been stimulated or suppressed by maintained diuretic or β-adrenoreceptor-blockade therapy. 3. Indomethacin administration produced no net effect on blood pressure in untreated patients with uncomplicated hypertension but it blunted or reversed the antihypertensive effect of either diuretic or propranolol therapy. 4. Salt and water retention may be an important factor in the blood pressure-raising effect of indomethacin during diuretic or propranolol therapy: In addition, prostaglandin synthesis may be important in counteracting increased α-adrenergic tone, which may limit the blood pressure-lowering effect of β-adrenoreceptor-blockade. 5. Because of these interactions and their pressor potential indomethacin should be used with caution when combined with either diuretics or β-adrenoreceptor blockers.

scholarly journals Long-Term Use of Aldosterone-Receptor Antagonists in Uncontrolled Hypertension: A Retrospective Analysis

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Pieter M. Jansen ◽  
Koen Verdonk ◽  
Ben P. Imholz ◽  
A. H. Jan Danser ◽  
Anton H. van den Meiracker
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Essential Hypertension ◽  
Primary Aldosteronism ◽  
Treatment Duration ◽  
Uncontrolled Hypertension ◽  
Receptor Antagonists ◽  
Aldosterone Receptor

Background. The long-term efficacy of aldosterone-receptor antagonists (ARAs) as add-on treatment in uncontrolled hypertension has not yet been reported.Methods. Data from 123 patients (21 with primary aldosteronism, 102 with essential hypertension) with difficult-to-treat hypertension who received an ARA between May 2005 and September 2009 were analyzed retrospectively for their blood pressure (BP) and biochemical response at first followup after start with ARA and the last follow-up available.Results. Systolic BP decreased by22±20and diastolic BP by9.4±12 mmHg after a median treatment duration of 25 months. In patients that received treatment >5 years, SBP was33±20and DBP was 16 ± 13 mmHg lower than at baseline. Multivariate analysis revealed that baseline BP and follow-up duration were positively correlated with BP response.Conclusion. Add-on ARA treatment in difficult-to-treat hypertension results in a profound and sustained BP reduction.

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