Pathophysiologic and pharmacokinetic determinants of the antihypertensive response to propranolol
Key result
Propranolol reduces blood pressure in a biphasic dose-response pattern based on plasma concentrations.
- n=23
Why the study?
Patients with essential hypertension show marked variability in antihypertensive response to propranolol, potentially due to pathophysiologic or pharmacokinetic differences.
What are the pathophysiologic and pharmacokinetic determinants of the antihypertensive response to propranolol in men with essential hypertension?
Population
23 men with mild to moderately severe essential hypertension
Comparison
Propranolol doses of 40 mg, 80 mg, and 320 mg daily
Design
Observational cohort study
Authors
Discussion
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Implication
Baseline traits may predict low-concentration response; leaves open randomized validation for individualized dosing.
Structured PICO
What are the pathophysiologic and pharmacokinetic determinants of the antihypertensive response to propranolol in men with essential hypertension?
P
Population
23 men with mild to moderately severe essential hypertension.
I
Intervention
Propranolol at three doses: 40 mg, 80 mg, and 320 mg daily
O
Outcome
Antihypertensive response (falls in blood pressure) and its relationship to plasma propranolol concentrations, plasma renin activity (PRA), and sympathetic nervous system activitysurrogate
The antihypertensive response to propranolol exhibits a biphasic dose-response relationship, with baseline sympathetic and renin activity predicting response only at lower plasma concentrations.
Cite This Study
Esler et al. (1977) studied essential hypertension (n=23). Propranolol was evaluated on Falls in blood pressure. Propranolol administration demonstrated a biphasic dose-response relationship for blood pressure reduction, with components at plasma concentrations of 3 to 30 ng/ml and above 30 ng/ml.