Lindner A, Douglas S W, Adamson J W
Ann Intern Med. 1978 Apr;88(4):457-62. doi: 10.7326/0003-4819-88-4-457.
We evaluated propranolol effects on blood pressure, plasma renin activity, and erythrocyte production in nine chronically hemodialyzed and four nondialyzed patients with hypertension and high plasma renin concentrations. Propranolol, at a maximum daily dose of 240 mg, controlled blood pressure in 12 of the 13 patients. During propranolol treatment of dialyzed patients, mean blood pressure fell from 133 +/- 1 to 113 +/- 4 mm Hg (P less than 0.005) and plasma renin activity from 3093 +/- 423 to 689 +/- 218 ng/dl 3h (P less than 0.001). Similar results were obtained in nondialyzed patients. In both groups hematocrit and red cell mass were unchanged, although ferrokinetic measurements suggested a decrease in erythropoiesis. Thus propranolol alone reduces blood pressure and renin activity in chronically dialyzed patients with hypertension and high renin concentrations. No hematologic complications or other side effects were observed. These findings suggest that propranolol may be an effective alternative to bilateral nephrectomy in the control of renin-dependent hypertension in selected patients.
我们评估了普萘洛尔对9例长期血液透析和4例未透析的高血压且血浆肾素浓度高的患者的血压、血浆肾素活性和红细胞生成的影响。普萘洛尔最大日剂量为240 mg时，13例患者中有12例血压得到控制。在对透析患者进行普萘洛尔治疗期间，平均血压从133±1 mmHg降至113±4 mmHg（P<0.005），血浆肾素活性从3093±423 ng/dl 3小时降至689±218 ng/dl（P<0.001）。在未透析患者中也得到了类似结果。两组患者的血细胞比容和红细胞量均未改变，尽管铁动力学测量提示红细胞生成减少。因此，单独使用普萘洛尔可降低长期透析的高血压且肾素浓度高的患者的血压和肾素活性。未观察到血液学并发症或其他副作用。这些发现表明，在选定患者中，普萘洛尔可能是双侧肾切除术控制肾素依赖性高血压的有效替代方法。
