Ten patients affected by essential moderate or severe hypertension were given five sequential treatments, each for three weeks: 1) placebo; 2) chlorthalidone (Cl) 100 mg daily; 3) Cl 50 mg + oxprenolol slow release (Ox) 160 mg daily; 4) Ox 160 mg; and 5) Ox 320 mg daily. Four poor responders (DPB ≥ 110 mmHg) received a subsequent administration of Ox 160 + Cl 50 + hydrallazine (Hydr) 25-100 mg daily. Both groups of patients showed the greatest antihypertensive action with Ox 160 + Cl 50 mg daily. Oxprenolol induced a similar hypotensive effectiveness at 160, as well as 320 mg/day. Analysis of the relationship between plasma renin activity (PRA) and antihypertensive response to each treatment resulted in the following conclusions: 1) Basal PRA levels cannot guide the determination of a preferential choice of diuretic or beta blocking therapy. 2) It is likely that renin activated by Cl and Hydr partially blunts their hypotensive activity. On the contrary, essential hypertension with normal or low PRA does not seem to depend on angiotensinogenic factors. 3) Oxprenolol remarkably inhibits the over production of renin induced by chlorthalidone and hydrallazine, in such way that it increases their antihypertensive action. 4) In the management of essential moderate or severe hypertension it is preferable to employ a mild dosage of beta blockers and diuretics, rather than use higher doses of a single agent.
|Translated title of the contribution||The role of renin after betablocking, diuretic and vasodilator treatment in essential hypertension|
|Number of pages||8|
|Journal||Giornale Italiano di Cardiologia|
|Publication status||Published - 1979|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine