Key result
Diuretics (furosemide and spironolactone) decreased mean arterial pressure by concurrently decreasing cardiac output and total peripheral resistance without decreasing total blood or plasma volume.
Why the study?
Do furosemide and spironolactone alter hemodynamic parameters in patients with marked peripheral edema and mild hypertension?
Do furosemide and spironolactone alter hemodynamic parameters in patients with marked peripheral edema and mild hypertension?
In patients with marked edema and mild hypertension, diuretics lower blood pressure by reducing interstitial fluid volume and increasing venous capacitance, which decreases cardiac output and peripheral resistance without reducing intravascular volume.
Hypertension develops in about 10% to 50% of patients with nephrosis or cirrhosis and peripheral edema, but the hemodynamic mechanism of the hypertension and its reversal by diuretic therapy has not been elucidated. In eight patients with marked edema and mild hypertension, diuretics (furosemide and spironolactone) decreased mean arterial pressure because of concurrent decrease in cardiac output and total peripheral resistance. Neither total blood volume nor plasma volume were decreased by the diuretics and the decrease in body weight was therefore attributed to the decrease in interstitial fluid volume. This, in turn, resulted in increased venous capacitance (as can be judged from the diuretic-induced decrease in the ratio of cardiopulmonary blood volume/total blood volume).
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Niarchos et al. (1982) studied Marked peripheral edema and mild hypertension (n=8). Diuretics (furosemide and spironolactone) was evaluated on Hemodynamic parameters (mean arterial pressure, cardiac output, total peripheral resistance). Diuretics (furosemide and spironolactone) decreased mean arterial pressure by concurrently decreasing cardiac output and total peripheral resistance without decreasing total blood or plasma volume.
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