Key result
Nadolol increases ERPF and preserves GFR, whereas propranolol reduces both.
Why the study?
The differential short-term renal haemodynamic effects of propranolol and nadolol in essential hypertension were not well characterized.
Does propranolol compared to nadolol affect effective renal plasma flow and glomerular filtration rate in patients with essential hypertension?
RCT (n=14)
Single-blind
random
Does propranolol compared to nadolol affect effective renal plasma flow and glomerular filtration rate in patients with essential hypertension?
In patients with essential hypertension, short-term therapy with propranolol has a renal vasoconstrictor effect, whereas nadolol has a vasodilator effect.
Nadolol may be preferred to propranolol in essential hypertension to avoid renal vasoconstriction; extends RCT evidence of heterogeneous beta-blocker effects on renal hemodynamics.
The effect of 4-6 weeks' treatment with propranolol and nadolol on effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) was studied, in 14 patients with essential hypertension, in single blind, random and cross-over design. Both drugs caused comparable effective lowering of pulse and blood pressure. When taken as the first drug, propranolol caused significant reduction in ERPF and GFR and a rise in filtration fraction (FF) and renal vascular resistance (RVR), whereas nadolol caused distinct rise in ERPF and a fall in FF and RVR but GFR remained unchanged. These haemodynamic effects were reduced when propranolol was given immediately after the withdrawal of nadolol and were obviated when nadolol followed propranolol therapy. This suggested a carry-over effect of the first drug into the second phase of treatment. We conclude that with short term therapy in essential hypertension, propranolol has a renal vasoconstrictor and nadolol a vasodilator effect.
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Danesh et al. (1984) conducted an RCT in essential hypertension (n=14). Propranolol vs. Nadolol was evaluated on Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR). Short-term therapy with propranolol acted as a renal vasoconstrictor by reducing ERPF and GFR, whereas nadolol acted as a vasodilator by increasing ERPF without changing GFR.
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