Document Detail


Hemodynamic changes during long-term thiazide treatment of essential hypertension in responders and nonresponders.
MedLine Citation:
PMID:  6987024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Blood pressure, cardiac output, plasma volume, renin, and aldosterone were measured in 13 patients with essential hypertension on placebo and after 1, 4, and 12 wk on hydrochlorothiazide 100 mg daily. In 9 patients the same variables were also measured after 24 and 36 wk. Hydrochlorothiazide lowered mean arterial pressure (p less than 0.01). Cardiac output was reduced after 4 and 12 wk of treatment, followed by a return to placebo levels. Stroke volume changed in the same way but heart rate and total peripheral resistance did not differ from placebo values. Plasma volume was reduced after 1 and 24 wk. Renin was permanently elevated (p less than 0.01), but aldosterone rose only during the first 12 wk of treatment. A comparison between responders (greater than 10% fall in mean arterial pressure) and nonresponders (less than 10% fall) revealed different hemodynamic patterns. In responders the initial fall in cardiac output was followed by a return to pretreatment levels, whereas in nonresponders it was permanently reduced. Consequently, total peripheral resistance was lowered only in responders. Nonresponders tended to show a greater degree of plasma volume depletion and greater stimulation of renin and aldosterone, which probably contributed to elevated peripheral resistance. It is concluded that changes in cardiac output are unlikely to be of decisive importance in the ultimate reduction of peripheral resistance in responders to thiazide therapy.
Authors:
P van Brummelen; A J Man in 't Veld; M A Schalekamp
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Clinical pharmacology and therapeutics     Volume:  27     ISSN:  0009-9236     ISO Abbreviation:  Clin. Pharmacol. Ther.     Publication Date:  1980 Mar 
Date Detail:
Created Date:  1980-05-14     Completed Date:  1980-05-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372741     Medline TA:  Clin Pharmacol Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  328-36     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aldosterone / blood
Blood Volume
Body Weight / drug effects
Diuresis
Hemodynamics / drug effects*
Humans
Hydrochlorothiazide / pharmacology,  therapeutic use*
Hypertension / drug therapy*,  physiopathology
Male
Middle Aged
Renin / blood
Time Factors
Chemical
Reg. No./Substance:
52-39-1/Aldosterone; 58-93-5/Hydrochlorothiazide; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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