What question did this study set out to answer?

To examine the effects of the angiotensin II antagonist saralasin on systemic and pulmonary hemodynamics in hypertensive patients across different sodium balance states.

September 1, 1978Clinical and Experimental Pharmacology and Physiology

Effects of 1‐sar‐8‐ala‐angiotensin Ii on Systemic and Pulmonary Haemodynamics in Hypertensive Patients

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Why the study?

Does intravenous saralasin alter systemic and pulmonary hemodynamics in hypertensive patients depending on their sodium status?

Key Points

To examine the effects of the angiotensin II antagonist saralasin on systemic and pulmonary hemodynamics in hypertensive patients across different sodium balance states.
Administered intravenous saralasin infusion at 10 μg/kg per min to 33 hypertensive patients.
Evaluated hemodynamics during a normal sodium diet (130 mmol/day) and during sodium depletion induced by a low-sodium diet (20 mmol/day) plus chlorthalidone.
Monitored intra-arterial pressure, heart rate, cardiac output, peripheral resistance, pulmonary vascular parameters, and plasma noradrenaline levels.
Saralasin induced an initial transient rise in systolic intra-arterial pressure peaking at 4 minutes (P < 0.01) and a 29.7% increase in plasma noradrenaline (P < 0.01), which was not correlated with the pressor response.
In sodium-depleted patients, mean arterial pressure fell by 17.8% and total peripheral resistance fell by 18.6% within 60 minutes (P < 0.001), whereas these variables remained unchanged in sodium-replete patients.
Pulmonary vascular resistance showed no change, but pulmonary capillary wedge pressure decreased by 1.2 mmHg (P < 0.01) alongside parallel reductions in pulmonary artery pressure (P < 0.01) during sodium depletion.

Structured PICO

Does intravenous saralasin alter systemic and pulmonary hemodynamics in hypertensive patients depending on their sodium status?

Population

33 hypertensive patients, evaluated on a normal sodium diet (130 mmol per day) and/or during sodium depletion by low sodium diet (20 mmol per day) and chlorthalidone.

Intervention

Saralasin (1-Sar-8-Ala-angiotensin II) infused intravenously at a rate of 10 μg/kg per min.

Comparator

Baseline hemodynamics prior to infusion, compared across sodium-replete and sodium-depleted states.

Outcome

Changes in intra-arterial pressure, heart rate, cardiac output, and total peripheral resistance.surrogate

Saralasin infusion effectively lowers blood pressure and peripheral resistance in sodium-depleted hypertensive patients, though it induces an initial transient pressor effect.

Discussion

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Implication

Supports saralasin's BP-lowering effect only in sodium-depleted patients; hypothesis-generating for sodium modulation of renin-angiotensin blockade.

Cite This Study

Fagard et al. (1978) studied this question.

synapsesocial.com/papers/6a90d48d647f40dea9c1a10f https://doi.org/10.1111/j.1440-1681.1978.tb00697.x

Topics

Hypertension management

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Implication

Supports saralasin's BP-lowering effect only in sodium-depleted patients; hypothesis-generating for sodium modulation of renin-angiotensin blockade.

Effects of 1‐sar‐8‐ala‐angiotensin Ii on Systemic and Pulmonary Haemodynamics in Hypertensive Patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Effects of 1‐sar‐8‐ala‐angiotensin Ii on Systemic and Pulmonary Haemodynamics in Hypertensive Patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider