Why the study?
Does administration of sympatholytic drugs reverse the reduction of renal perfusion in men with sustained essential hypertension?
Does administration of sympatholytic drugs reverse the reduction of renal perfusion in men with sustained essential hypertension?
The reduction of renal perfusion in essential hypertension is partly reversible with centrally acting sympatholytics (clonidine, alpha-methyldopa), suggesting it is driven by adrenergic system abnormalities.
Reversal of reduced renal perfusion by clonidine or methyldopa but not propranolol is hypothesis-generating; randomized trials needed before clinical consideration.
Cardiac output (CO), renal blood flow (RBF), calf blood flow (CBF), and hepatic blood flow (HBF), glomerular filtration rate (GFR), and dopamine beta hydroxylase (D beta H) activity were studied in 198 men (67 normotensive controls and 131 hypertensive patients) of the same age with sustained uncomplicated essential hypertension. In the hypertensive men, the RBF and the RBF/CO ratio were significantly decreased (p less than 0.001). The RBF and RBF/CO ratio were negatively correlated with age (p less than 0.01), blood pressure (p less than 0.01), and D beta H activity (p less than 0.01). None of these relationships were observed with CBF and HBF. The observed decreases in RBF and the RBF/CO ratio in hypertensive men were reversed after administration of clonidine and alpha-methyldopa (p less than 0.01), but not after administration of propranolol. The study provides evidence that the reduction of renal perfusion in essential hypertension is partly reversible and related to an abnormality in the adrenergic system control.
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London et al. (1984) studied this question.
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