Decreased Renal Plasma Flow during Propranolol Treatment in Essential Hypertension

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Abstract
The pharmacodynamic effect of propranolol (80 mg bid [twice daily]) on the renal and systemic circulation was studied after 1 and 8 mo. of treatment in 13 patients with essential hypertension, using non-invasive radioisotope techniques. Effective renal plasma flow (ERPF) fell from (mean .+-. SEM) 244 .+-. 18 to 208 .+-. 14 after 1 mo. and to 187 .+-. 13 ml/min .cntdot. m2 after 8 mo. of treatment. Cardiac index (CI) fell from 3.24 .+-. 0.15 to 2.62 .+-. 0.11 and 2.75 .+-. 0.10 l/min .cntdot. m2, respectively. The correlation coefficient between the decreases in ERPF and CI was 0.49. Mean arterial blood pressure decreased from 138 .+-. 5 to 118 .+-. 5 and 116 .+-. 4 mmHg, respectively. Left ventricular work was reduced by 30.2 and 27%, while peripheral resistance was unchanged. Total plasma volume was increased from 19.3 .+-. 0.5 to 20.3 .+-. 0.6 ml/cm after 1 mo., but was within the same range as the control values after 8 mo. of treatment. Pulmonary plasma volume was unchanged, indicating that there was no pooling of plasma in the pulmonary circulation. The interventricular circulation time was increased from 6.9 .+-. 0.4 s to 8.4 .+-. 0.3 s and varied with the change in heart rate. The fall in ERPF might be explained by reduced cardiac output in addition to interference with the hemodynamic autoregulation in the kidney.

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