Effects of beta blockade with acebutolol on hypertension, hemodynamics, and fluid volume

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Abstract
Eleven patients with essential hypertension were treated with the beta adrenergic blocker, acebutolol. Clinical, systemic, and regional hemodynamic and biochemical studies were performed before and after 4 wk of acebutolol therapy (average dose, 1,200 mg/day.) In 4 patients there was a reduction in mean arterial pressure ≥10 mm Hg; there was none in the remainder. Regardless of the blood pressure response, the renin secretory index did not change. Although cardiac output did not change, renal blood flow fell (p < 0.005) without relation to response of arterial pressure. Supine heart rate decreased (p < 0.05), so also the responses to upright tilt (p < 0.01) and isometric exercise (p < 0.02). These results demonstrate that in those patients with a hypotensive response to acebutolol, the clinical effect was not related to reduced cardiac output or plasma renin activity, further adding to confusion on the mechanism of the lowering of elevated blood pressure by beta adrenergic blockade.