What question did this study set out to answer?

To assess the effects of sequential sodium depletion and propranolol treatment on blood pressure, body fluid volumes, and plasma renin activity in essential versus renovascular hypertension.

January 1, 1974Clinical Science

Effect of Volume Depletion and Subsequent Propranolol Treatment on Blood Pressure and Plasma Renin Activity in Patients with Essential and with Renovascular Hypertension

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Why the study?

Does propranolol treatment after volume depletion reduce blood pressure and plasma renin activity in patients with essential and renovascular hypertension?

Population

19 patients, including 5 with unilateral renal artery stenosis and 14 with essential hypertension

Comparison

Sequential treatment consisting of: at least 3… vs Baseline and prior sequential periods

Design

Cohort

Follow-up

At least 9 days

Authors

GGG. G. GeyskesHypertension Institute PBPoppo H. BoerUniversity of Ottawa FLF. H. H. LeenenUniversity of Ottawa

Discussion

Member takes

Implication

May support propranolol after sodium depletion in hypertension; leaves open renin-independent mechanisms and generalizability.

Key Points

To assess the effects of sequential sodium depletion and propranolol treatment on blood pressure, body fluid volumes, and plasma renin activity in essential versus renovascular hypertension.
Studied 19 patients, including 14 with essential hypertension (WHO grades I–II) and 5 with unilateral renal artery stenosis.
Evaluated outcomes across three sequential 3-day phases: baseline (60 mmol Na+ diet), diuretic-induced sodium depletion (20 mmol Na+ diet), and continued sodium restriction combined with propranolol escalated up to 320 mg daily.
Measured blood pressure, plasma volume, extracellular fluid volume, and plasma renin activity at the conclusion of each phase.
Sodium depletion significantly lowered plasma volume and extracellular fluid volume while increasing plasma renin activity, but did not significantly alter blood pressure.
Subsequent propranolol administration maintained reduced fluid volumes while significantly decreasing both plasma renin activity and blood pressure.
Antihypertensive responses showed no correlation with changes in plasma renin activity and did not differ significantly between essential hypertension and renal artery stenosis.

Structured PICO

Does propranolol treatment after volume depletion reduce blood pressure and plasma renin activity in patients with essential and renovascular hypertension?

Population

19 patients, including 5 with unilateral renal artery stenosis and 14 with essential hypertension (WHO grades I-II)

Intervention

Sequential treatment consisting of: (a) at least 3 days on a 60 mmol Na+ diet; (b) 3 days of salt depletion induced with a diuretic and sustained on a 20 mmol Na+ diet; (c) 3 days of continued 20 mmol Na+ diet with beta-receptor blockade induced by increasing dosages of propranolol up to 320 mg daily

Comparator

Baseline and prior sequential periods (within-subject comparison)

Outcome

Changes in blood pressure and plasma renin activitysurrogate

Propranolol exerts a strong anti-hypertensive effect after sodium depletion in patients with essential or renovascular hypertension, independent of absolute plasma renin activity.

Cite This Study

Geyskes et al. (1974) studied this question.

synapsesocial.com/papers/6a71df50c1a24a6142dbc350 https://doi.org/10.1042/cs048069s

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Effect of Volume Depletion and Subsequent Propranolol Treatment on Blood Pressure and Plasma Renin Activity in Patients with Essential and with Renovascular Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Effect of Volume Depletion and Subsequent Propranolol Treatment on Blood Pressure and Plasma Renin Activity in Patients with Essential and with Renovascular Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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