Why the study?
Does hydrochlorothiazide treatment alter sympathetic activity and hemodynamics in hypertensive patients?
Does hydrochlorothiazide treatment alter sympathetic activity and hemodynamics in hypertensive patients?
Hydrochlorothiazide induces sustained sympathetic hyperactivity in hypertensive patients, providing a pathophysiological rationale for combining diuretics with sympatholytic drugs.
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May support combining hydrochlorothiazide with sympatholytics in hypertension; hypothesis-generating from Level 3 data, should not yet change practice.
Hydrochlorothiazide-induced diuresis and natriuresis is considered to be responsible for the antihypertensive effect of this drug. After short-term treatment there is decreased cardiac output and increased peripheral resistance which we have found to be attended by increased plasma norepinephrine (NE) levels. After longer treatment cardiac output returns to normal and peripheral resistance declines. At this time, plasma NE levels remain elevated, indicating that peripheral resistance reduction is not a consequence of a reduction of the elevated level of sympathetic activity. These results provide a rationale for the combined use of diuretics and drugs which diminish noradrenergic activity in the treatment of hypertension.
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Lake et al. (1979) studied this question.
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