Summary
Adrenergic receptors in the kidney mediate changes in renal blood flow. α-Adrenoceptor stimulation results in vasoconstriction while stimulation of β1-adrenoceptors has a similar effect mediated through the renin- angiotensin system. On the other hand, β2-adrenoceptors mediate direct vasodilatation. Therefore adrenoceptor blockade may be expected to alter renal blood flow.
In general, in young patients, cardioselective drugs tend to reduce renal blood flow. However, little data are available on the effects of β-blockade in elderly patients. As hypertension in this group differs in many respects from that in young patients, we observed the anti-hypertensive and renal effects of atenolol, nadolol and labetalol in elderly hypertensive patients.
Our data suggest that in the elderly, β-blocking drugs are effective antihypertensive agents but they have disparate effects on renal blood flow. Cardioselective agents appear to have less tendency to reduce renal blood flow than non-selective ones. However, the clinical significance of such changes in renal blood flow in the presence of unaltered glomerular filtration rate and normal biochemical indices of renal function remains to be elucidated.
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O’Malley, K., O’Callaghan, W.G., Laher, M.S. et al. β-Adrenoceptor Blocking Drugs and Renal Blood Flow with Special Reference to the Elderly. Drugs 25 (Suppl 2), 103–107 (1983). https://doi.org/10.2165/00003495-198300252-00033
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DOI: https://doi.org/10.2165/00003495-198300252-00033