Propranolol treatment reduced plasma renin activity but did not transform primary hypertensive patients into low renin hypertensives specifically sensitive to diuretic treatment.
RCT (n=19)
random succession
Does propranolol suppress plasma renin activity during diuretic treatment and cause additional blood pressure fall in primary hypertensive patients?
Propranolol treatment does not transform primary hypertensive patients into 'low renin hypertensives' who are specifically sensitive to diuretic treatment.
Abstract. 19 primary hypertensive patients were treated in random succession with diuretic, propranolol and the combination of both. It was found that the diuretic gave a sustained increase in plasma renin activity (PRA). There was a negative correlation between PRA level attained and blood pressure reduction. Propranolo treatment gave a sustained reduction of PRA. There was no correlation between PRA reduction and blood pressure reduction. When diuretic was combined with propranolol, PRA was in average at con trol level, and there was no correlation between the PRA reduction from diuretic value to combination value and the corresponding additional blood pressure fall. It is concluded that propranolol treatment does not transform patients to “low renin hypertensives specifically sensitive to diuretic treatment. Plasma renin as a patogenic factor in primary hypertension and a paramenter worth measuring to chose therapy has been a controversial subject, since Bühler et al. (2) found that “high renin hypertension” responded hest to propranolol treatment, and there was a significant correlatinn between fall in plasma renin activity and fall in blood pressure. Only very few investigators have been able to reproduce these findings. That plasma renin activity indeed is a blood pressure determinant was supported by Haber et al. (6), who found that normotensives only during salt depletion (with consequently high renin) responded to inhibitor to converting enzyme (impeding angiotensin II production) with blood pressure fall during orthostasis. The observations by Douglas et al. (4) that “low renin hypertensives” responded best to diuretic treatment has added evidence to the contention. The object of the present study was to establish, whether propranolol could suppress plasma renin activity during diuretic treatment. Further to evaluate whether a possible renin suppression had made the patimt a “low renin hypertensive” with a pronounced additional blood pressure fall during combined propranolol and diuretic treatment.
Nielsen et al. (Wed,) conducted a rct in primary hypertension (n=19). Propranolol and diuretic vs. Diuretic alone, propranolol alone, and combination was evaluated on Plasma renin activity (PRA) and blood pressure reduction. Propranolol treatment reduced plasma renin activity but did not transform primary hypertensive patients into low renin hypertensives specifically sensitive to diuretic treatment.