The Effect of Chronic Adrenergic Receptor Blockade on Plasma Renin Activity in Man

1972 ◽  
Vol 34 (2) ◽  
pp. 386-394 ◽  
Author(s):  
A. M. MICHELAKIS ◽  
R. G. MCALLISTER
Keyword(s):  
Plasma Renin Activity ◽  
Adrenergic Receptor ◽  
Plasma Renin ◽  
Renin Activity ◽  
Receptor Blockade ◽  
Adrenergic Receptor Blockade

Quantitative Effects of Timolol and Hydrochlorothiazide on Blood Pressure, Heart Rate and Plasma Renin Activity: Results of a Double-Blind Factorial Trial in Patients with Essential Hypertension

1976 ◽  
Vol 51 (s3) ◽  
pp. 517s-519s
Author(s):  
J. P. Chalmers ◽  
J. S. Horvath ◽  
P. I. Korner ◽  
D. J. Tiller ◽  
A. J. Bune ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Plasma Renin ◽  
Renin Activity ◽  
Receptor Blockade ◽  
Double Blind ◽  
Receptor Blocking ◽  
Placebo Phase ◽  
Factorial Trial ◽  
Β Receptor

1. The anti-hypertensive actions of timolol and hydrochlorothiazide were analysed in a double-blind 2 × 2 factorial trial in twenty patients with essential hypertension. Each patient went through four phases of 8 weeks in randomized order, receiving timolol alone, hydrochlorothiazide alone, timolol plus hydrochlorothiazide, and placebo. 2. Supine mean arterial pressure fell from 119 mmHg in the placebo phase, to 110 mmHg during the thiazide phase, 106 mmHg during the timolol phase, and to 101 mmHg during the combined timolol plus hydrochlorothiazide phase. 3. Factorial analysis revealed that the hypotensive actions of the β-receptor-blocking drug and the diuretic were additive, without any synergism or antagonism. 4. Plasma renin activity measured in ng 3 h—1 ml—1 rose from 502 in the placebo phase to 9·54 in the diuretic phase, but fell to 1·79 in the β-receptor blockade. It was unchanged in the combined therapy phase, despite the greater drop in blood pressure. These results suggest that the fall in plasma renin activity during β-receptor blockade is of little importance in the hypotensive action of β-receptor-blocking drugs.

scholarly journals Minireview: Primary Aldosteronism—Changing Concepts in Diagnosis and Treatment

Endocrinology ◽  
2003 ◽  
Vol 144 (6) ◽  
pp. 2208-2213 ◽  
Author(s):  
William F. Young
Keyword(s):  
Plasma Renin Activity ◽  
Primary Aldosteronism ◽  
Activity Ratio ◽  
Cardiovascular Effects ◽  
Plasma Renin ◽  
Plasma Aldosterone ◽  
Renin Activity ◽  
Receptor Blockade ◽  
Plasma Aldosterone Concentration ◽  
Aldosterone Producing Adenoma

Abstract Primary aldosteronism affects 5–13% of patients with hypertension. Patients with hypertension and hypokalemia and most patients with treatment-resistant hypertension should undergo screening for primary aldosteronism with a plasma aldosterone concentration to plasma renin activity ratio. A high plasma aldosterone concentration to plasma renin activity ratio is a positive screening test result, a finding that warrants confirmatory testing. For those patients that want to pursue a surgical cure, the accurate distinction between the subtypes (unilateral vs. bilateral adrenal disease) of primary aldosteronism is a critical step. The subtype evaluation may require one or more tests, the first of which is imaging the adrenal glands with computed tomography, followed by selective use of adrenal venous sampling. Because of the deleterious cardiovascular effects of aldosterone, normalization of circulating aldosterone or aldosterone receptor blockade should be part of the management plan for all patients with primary aldosteronism. Unilateral laparoscopic adrenalectomy is an excellent treatment option for patients with unilateral aldosterone-producing adenoma. Bilateral idiopathic hyperaldosteronism should be treated medically. In addition, aldosterone-producing adenoma patients may be treated medically if the medical treatment includes mineralocorticoid receptor blockade.

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