Contrasting effects of acute beta blockade with propranolol on plasma catecholamines and renin in essential hypertension: a possible basis for the delayed antihypertensive response

Alberto Morganti, Thomas G. Pickering, Jorge A. Lopez-Ovejero, John H. Laragh

Research output: Contribution to journalArticlepeer-review

Abstract

Blood pressure, heart rate, plasma renin activity, plasma norepinephrine and plasma epinephrine were determined in 11 patients with essential hypertension at rest before and 15, 30, 45, and 60 minutes after an intravenous infusion of 0.12 mg./Kg. propranolol given over five minutes. After propranolol mean blood pressure was unchanged; heart rate decreased by 14 per cent within 15 minutes and showed no further changes. Plasma renin activity decreased progressively by 48 per cent 60 minutes after propranolol, whereas plasma norepinephrine and epinephrine were always higher after propranolol than control values. Increases in norepinephrine were statistically significant at 30, 45, and 60 minutes (respectively 49, 39, and 45 per cent, P <0.005 at least) and those of epinephrine even at 15 minutes (respectively 60, 82, 62, and 94 per cent, P <0.01 for all). These results indicate that acute beta blockade with propranolol induces increases in circulating plasma norepinephrine and epinephrine which might be consequent to rapidly induced hemodynamic changes. This augmented sympathetic activity might explain why propranolol, when acutely infused, does not decrease blood pressure despite effective cardiac and renin blockade.

Original languageEnglish
Pages (from-to)478-489
Number of pages12
JournalAmerican Heart Journal
Volume98
Issue number4
DOIs
Publication statusPublished - 1979

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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