Increased Plasma Noradrenaline Concentrations in Essential Hypertension and Their Decrease after Long-Term Treatment with a β-Receptor-Blocking Agent (Prindolol)

1. Plasma noradrenaline was measured in fiftynine patients with mild to severe essential hypertension and in fifteen normotensive control subjects under basal and orthostatic conditions. 2. In patients with essential hypertension mean plasma noradrenaline concentrations were significantly higher than in control subjects under basal and orthostatic conditions. 3. In patients with essential hypertension basal diastolic blood pressure correlated closely with the corresponding plasma noradrenaline concentrations. 4. Long-term treatment with prindolol of patients with essential hypertension led to a significant fall in diastolic and systolic blood pressure and heart rate and to a significant decrease in plasma noradrenaline concentrations under basal and orthostatic conditions. 5. The adrenergic response to upright posture, reflected by an increase in plasma noradrenaline, was not abolished by prindolol. 6. It is concluded that the anti-hypertensive effect of prindolol in patients with essential hypertension is at least partially mediated by a decrease of sympathetic nervous activity.

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Haemodynamic Effects of Withdrawal of Long-Term Treatment with β-Adrenoceptor Blocking Agents in Subjects with Essential Hypertension

Clinical Science ◽

10.1042/cs061421s ◽

1981 ◽

Vol 61 (s7) ◽

pp. 421s-423s ◽

Cited By ~ 4

Author(s):

C. Bengtsson ◽

Y. Larsson ◽

V. Panfilov ◽

R. Sivertsson ◽

H. Åström

Keyword(s):

Blood Pressure ◽

Cardiac Output ◽

Essential Hypertension ◽

Structural Changes ◽

Peripheral Resistance ◽

Blocking Agent ◽

Term Treatment ◽

First Year ◽

Long Term Treatment

1. After 10 years of β-adrenoceptor blockade in five female patients with essential hypertension, the β-adrenoceptor-blocking agent was withdrawn, and the women were then followed up for 1 year, with measurements of cardiac output and peripheral resistance. 2. Blood pressure remained low during the first year after withdrawal in spite of the fact that the heart rate increased within the first few days. 3. Cardiac output was found to increase during the first year after withdrawal, although total peripheral resistance was essentially unchanged. 4. The maintenance of low blood pressure after withdrawal of the antihypertensive drug might indicate a regression of structural changes in the resistance vessels during successful long-term antihypertensive treatment. 5. Minimal resistance in hands and calves did not increase during the year after withdrawal.

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Plasma Adrenaline and Noradrenaline in Essential Hypertension and after Long-Term Treatment with β-Adrenoreceptor-Blocking Agents

Clinical Science ◽

10.1042/cs055097s ◽

1978 ◽

Vol 55 (s4) ◽

pp. 97s-100s ◽

Cited By ~ 1

Author(s):

R. Franco-Morselli ◽

M. Baudouin-Legros ◽

P. Meyer

Keyword(s):

Essential Hypertension ◽

Term Treatment ◽

Plasma Noradrenaline ◽

Adrenergic System ◽

Plasma Adrenaline ◽

Hypertensive Patients ◽

Control Subjects ◽

Blocking Agents ◽

Long Term Treatment

1. Plasma adrenaline and noradrenaline were measured in supine and upright positions in 27 essential hypertensive patients and in 12 age-matched control subjects. 2. Plasma adrenaline was markedly increased in a large proportion of patients, compared with control subjects, either in supine or in upright positions, whereas no significant differences were found in plasma noradrenaline. 3. Six hypertensive patients were chronically treated with β-adrenoreceptor-blocking agents (five with propranolol and one with pindolol). Plasma noradrenaline was not significantly changed in the supine position but was markedly increased on standing in four out of six patients. Plasma adrenaline was decreased in five out of six patients either in supine or upright positions. 4. These findings support the view that the adrenergic system participates in the mechanism of essential hypertension.

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Hemodynamic and Endocrinological Effects of a New Selective 1-Blocking Agent, Terazosin, in Patients With Essential Hypertension Results of Long-Term Treatment

American Journal of Hypertension ◽

10.1093/ajh/2.11.834 ◽

1989 ◽

Vol 2 (11 Pt 1) ◽

pp. 834-839 ◽

Cited By ~ 5

Author(s):

F. Tomoda ◽

M. Takata ◽

K. Yoshida ◽

K. Yasumoto ◽

M. Mikawa ◽

...

Keyword(s):

Essential Hypertension ◽

Blocking Agent ◽

Term Treatment ◽

Long Term Treatment

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Interaction of Dopamine, Methyldopa and Reserpine in the Sympatho-Adrenal System in Essential Hypertension

Clinical Science ◽

10.1042/cs051461s ◽

1976 ◽

Vol 51 (s3) ◽

pp. 461s-463s

Author(s):

K. Abe ◽

H. Aoyagi ◽

M. Yasujima ◽

S. Miyazaki ◽

T. Kusaka ◽

...

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Peripheral Nerve ◽

Pressor Response ◽

Normal Subjects ◽

Term Treatment ◽

Adrenal System ◽

Long Term Treatment ◽

Depressor Effect

1. The interactions of dopamine, reserpine and methyldopa on blood pressure of normal subjects and of those with essential hypertension were examined. 2. When biosynthesis of noradrenaline from dopamine was blocked by reserpine, dopamine induced a prominent depressor effect in essential hypertension. 3. The long-term treatment with methyldopa induced a marked potentiation of the pressor action of domapine in hypertension, although no significant pressor response was found in normal subjects. 4. It is suggested that methylnoradrenaline may accumulate in peripheral nerve endings of patients with essential hypertension in comparison with normal subjects, and this accumulated methylnoradrenaline potentiates the pressor response to dopamine in essential hypertension.

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Long-Term Treatment of Essential Hypertension with Nadolol and Hydrochlorothiazide: A Two-Year Follow-Up

Journal of International Medical Research ◽

10.1177/030006058201000203 ◽

1982 ◽

Vol 10 (2) ◽

pp. 87-91 ◽

Cited By ~ 1

Author(s):

M M El-Mehairy ◽

A Shaker ◽

M Ramadan ◽

S Hamza ◽

S S Tadros

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Combined Therapy ◽

Term Treatment ◽

Once Daily ◽

Supine Blood Pressure ◽

End Of Treatment ◽

Long Term Treatment ◽

Adrenergic Blocker

After 3 weeks of placebo administration, thirty-two mildly or moderately hypertensive patients were treated with hydrochlorothiazide (HCZ) for 3 weeks, then with HCZ plus nadolol, a new beta-adrenergic blocker, for 2 years. The dose of HCZ was 50 mg once daily for all except two patients, who received 50 mg twice a day. The dose of nadolol ranged from 40 mg to 240 mg, once daily. The average supine blood pressure decreased from 182/110 mm Hg at the end of the placebo period to 170/104 mm Hg at the end of treatment with HCZ alone. Nadolol was added to the regimen, and the average supine blood pressure decreased further to 132/88 mm Hg at the end of 3 months of combined therapy. It remained essentially unchanged for the duration of the 2-year study, and no increases in the dosage of either drug were needed. Side-effects were mild, and none required a change in dosage. A once-daily dose of nadolol combined with HCZ appears to be safe and effective therapy for the long-term treatment of mild or moderate essential hypertension.

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