Summary
Arterial blood pressure and plasma catecholamines, renin activity and aldosterone concentration in 12 patients with severe essential hypertension were studied before and after combined α-and β-adrenergic receptor blockade induced by oral labetalol treatment for 2 months. Furosemide in a fixed dose was employed as a basic antihypertensive agent throughout the study. Blood pressure was adequately controlled in only 6 patients. Mean body weight increased by 1.8 kg and there was a rise in body weight which was inversely correlated with the fall in standing mean blood pressure. The mean plasma noradrenaline concentration decreased from 0.30 to 0.20 ng/ml, whereas plasma adrenaline did not change significantly. Plasma renin activity and aldosterone concentration varied greatly, but the mean values did not change significantly. Change in body weight was correlated inversely with changes in plasma noradrenaline and renin. The results suggest that labetalol, through its combined α- and β-adrenergic receptor blocking action, induces a rise in body weight, probably due to sodium and fluid retention, which partly counterbalances the antihypertensive effect of labetalol, and partly modifies both renin and sympathetic nervous activity.
Similar content being viewed by others
References
Lake, C. R., Kopin, I. J., Ziegler, M. G., Coleman, M. D.: Plasma catecholamines and neurogenic hypertension. New Engl. J. Med.297, 53–54 (1977)
Pedersen, E. B., Christensen, N. J.: Catecholamines in plasma and urine in patients with essential hypertension determined by double-isotope derivative techniques. Acta Med. Scand.198, 373–377 (1975)
Birkenhäger, W. H., Schalekamp, M. A.: Control mechanisms in essential hypertension. p. 111. Amsterdam: Elsevier 1976
Bühler, F. R., Laragh, J. H., Baer, L., Vaughan, E. D., Brunner, H. R.: Propranolol inhibition of renin secretion. A specific approach to diagnosis and treatment of renindependent hypertensive diseases. New Engl. J. Med.287, 1209–1214 (1972)
Shand, D., Frisk-Holmberg, M., McDevitt, D., Sherman, K., Hollifield, J.: A dual antihypertensive mechanism for propranolol based on plasma level/response relationships. In: Pathophysiology and management of arterial hypertension. Berglund, G., Hansson, L., Werkö, L. (ed.), pp. 175–182. Göteborg: Lindgren & Söner 1975
Pettinger, W. A., Keeton, K.: Altered renin release and propranolol potentiation of vasodilatory drug hypotension. J. Clin. Invest.55, 236–243 (1975)
Christensen, N. J.: Plasma noradrenaline and adrenaline in patients with thyreotoxicosis and myxoedema. Clin. Sci. Mol. Med.45, 163–171 (1973)
Giese, J., Jørgensen, M., Nielsen, M. D., Lund, J. O., Munck, O.: Plasma renin concentration measured by use of radioimmunoassay for angiotensin I. Scand. J. Clin. Lab. Invest.26, 355–368 (1970)
Rask-Madsen, J., Bruusgaard, A., Munck, O., Nielsen, M. D., Worning, H.: The significance of bile acids and aldosterone for the electrical hyperpolarization of human rectum in obese patients treated with intestinal by-pass operation. Scand. J. Gastroenterol.9, 417–426 (1974)
Ibsen, H., Rasmussen, K., Jensen, H. Æ., Leth, A.: Changes in plasma volume and extracellular fluid volume after addition of prazosin to propranolol treatment in patients with hypertension. Scand. J. Clin. Lab. Invest.38, 425–429 (1978)
Ibsen, H., Rasmussen, K., Jensen, H. Æ., Leth, A.: Changes in plasma volume and extracellular fluid volume after addition of hydralazine to propranolol treatment in patients with hypertension. Acta Med. Scand.203, 419–423 (1978)
Weidmann, P., De Chatel, R., Ziegler, W. H., Flammer, J., Reubi, F.: Alpha and beta adrenergic blockade with orally administered labetalol in hypertension. Studies on blood volume, plasma renin and aldosterone and catecholamine excretion. Am. J. Cardiol.41, 570–576 (1978)
Richards, D. A.: Pharmacological effects of labetalol in man. Br. J. Clin. Pharmacol.3, Suppl. 3, 721–723 (1976)
Galbo, H., Christensen, N. J., Holst, J. J.: Catecholamines and pancreatic hormones during autonomic blockade in exercising man. Acta Physiol. Scand.101, 428–437 (1977)
Christensen, N. J., Trap-Jensen, J., Clausen, J. P., Noer, I., Krogsgaard, A. R., Larsen, O. A.: Effect of beta-receptor blockade on heart rate, hepatic blood flow and circulating noradrenaline during exercise in man. Acta Physiol. Scand.95, 62A-63A (1975)
Galbo, H., Christensen, N. J., Holst, J. J.: Glucose-induced decrease in glucagon and epinephrine responses to exercise in man. J. Appl. Physiol.42, 525–530 (1977)
Hansen, J. F., Hesse, B., Christensen, N. J.: Enhanced sympathetic nervous activity after intravenous propranolol in ischaemic heart disease: Plasma noradrenaline, splanchnic blood flow and pulmonary artery oxygen saturation at rest and during exercise. Eur. J. Clin. Invest.8, 31–36 (1978)
Christensen, N. J., Trap-Jensen, J., Svendsen, T. L., Rasmussen, S., Nielsen, P. E.: Effect of labetalol on plasma noradrenaline and adrenaline in hypertensive man. Eur. J. Clin. Pharmacol.14, 227–230 (1978)
Hamilton, C. A., Jones, D. H., Dargie, H. J., Reid, J. L.: Does labetalol increase excretion of urinary catecholamines. Br. Med. J.1978/II, 800
Harris, D., Richards, D. A. Labetalol and urinary catecholamines. Br. Med. J.1977/II, 1673
Chapman, B. P., Veitch, A. G., Shepherd, B.: Labetalol and urinary catecholamines. Br. Med. J.1978/I, 364
Davis, J. O., Freeman, R. H.: Mechanisms regulating renin release. Physiol. Rev.56, 1–56 (1976)
Pedersen, E. B., Kornerup, H. J.: Plasma renin concentration in essential hypertension during beta-adrenergic blockade and vasodilator therapy. Eur. J. Clin. Pharmacol.12, 93–96 (1977)
Hedeland, H., Dymling, J. F., Hökfelt, B.: The effect of insulin-induced hypoglycaemia on plasma renin activity and urinary catecholamines before and following clonidine in man. Acta Endocrinol. (Kbh.)71, 321–330 (1972)
Vander, A. J.: Effect of catecholamines and the renal nerves on renin secretion in anesthetized dogs. Am. J. Physiol.209, 659–662 (1965)
Peach, M. J.: Adrenal medullary stimulation induced by angiotensin. Circ. Res. Suppl.II, 107–117 (1971)
Williams, G. H., Dluhy, R. G.: Aldosterone biosynthesis. Interrelationship of regulatory factors. Am. J. Med.53, 595–605 (1972)
Pedersen, E. B., Kornerup, H. J. Relationship between plasma aldosterone concentration and plasma potassium in patients with essential hypertension during alprenolol treatment. Acta Med. Scand.200, 263–267 (1976)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kornerup, H.J., Pedersen, E.B., Christensen, N.J. et al. Effect of oral labetalol on plasma catecholamines, renin and aldosterone in patients with severe arterial hypertension. Eur J Clin Pharmacol 16, 305–310 (1979). https://doi.org/10.1007/BF00605626
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00605626