Antihypertensive action of propranolol

摘要: The antihypertensive effect of propranolol was evaluated in 96 patients with various forms hypertension preclassified according to plasma renin activity considered relation urinary sodium excretion. In essential (no = 74) 74 percent high-renin (14 19) exhibited striking blood pressure reductions and 66 normal-renin (25 38) achieved diastolic pressures less than or equal 95 mm Hg. sharp contrast, completely ineffective 17 low-renin patients. all 11 unilateral renal artery parenchymal disease also lowered proportion control levels. response predictive the benefit surgery even six “normal” eight malignant hypertension, normalized renin, aldosterone potassium levels produced dramatic though often incomplete correction. one patient syndrone ineffective. Regardless etiology, effectiveness correlated decrement secretion. Thus, a simple biochemical measurement indexed against excretion predicted drug responsiveness. These observations expose, for first time, role major fraction hypertension. Renin-induced vasoconstriction appears cause high some normal whom may be inappropriately balance. action strikes at both vasoconstrictor volume components since inhibition secretion naturally retards secretion, thus preventing compensatory salt water retention which vitiates hypotensive therapy. Accordingly, added either vasodilator diuretic agents ought improve by curtailing reactive increases aldosterone: this should reduce diuretic-induced loss. Propranolol given alone prove effective sizeable hypertensive disorders without inducing dehydrated hyperreninemic state caused diuretics. Therefore an alternate approach, except lowrenin hypertensions where type therapy is contraindicated.