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Effects of chronic alpha and beta adrenoceptor blockade with labetalol on plasma catecholamines and renal function in hypertension

Chronische Alpha- und Betarezeptoren-Blockade mit Labetalol bei essentieller Hypertonie: Effekt auf Plasmakatecholamine und Nierenfunktion

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Zusammenfassung

Bei 18 Patienten mit essentieller Hypertonie wurde der Einfluß einer chronischen Alpha-und Betarezeptoren-Blockade mit Labetalol auf Plasmakatecholamine und Nierenfunktion untersucht. Plasmanoradrenalin und Adrenalin veränderten sich nach 6wöchiger Behandlung nicht signifikant, während die glomeruläre Filtrationsrate und der renale Plasmafluß um ungefähr 20% abnahmen (P<0,025). Die tubuläre Rejektionsfraktion von Natrium nahm um 36% zu (P<0.001), bei unveränderter Natrium-Ausscheidung im 24 h-Urin. Der geringgradige Abfall der glomerulären Filtrationsrate und des renalen Plasmaflusses scheint nur von geringer klinischer Bedeutung zu sein. Der fehlende Anstieg der Plasmakatecholamine unter der chronischen Alpha-und Betarezeptoren-Blockade mit Labetalol ist vereinbar mit einer selektiven postsynaptischen alpha-blockierenden Wirkung, während die präsynaptische Feedbackkontrolle der Katecholaminausschüttung unbeeinflußt bleibt. Zudem scheint die blutdrucksenkende Wirkung von Labetalol von Änderungen der Aktivität des sympathischen Nervensystems weitgehend unabhängig zu sen.

Summary

Plasma catecholamines and renal function were evaluated in 18 patients with essential hypertension treated with the alpha and beta adrenoceptor blocking agent, labetalol. Following 6 weeks of labetalol therapy, blood levels of epinephrine and norepinephrine remained unaltered. Glomerular filtration rate and renal plasma flow were decreased similarly by about 20% (P<0.025). Tubular rejection fraction of sodium was increased by 36% (P<0.001) while sodium excretion was comparable to control conditions. Labetalol's potential to cause a mild reduction in kidney function should be considered, but may have no clinical consequences in most hypertensive patients receiving such treatment. The lack of increased plasma catecholamine levels during therapy supports the concept that labetalol's alpha-blocking potential is limited to post-junctional receptors, leaving the prejunctional feedback control of catecholamine release intact. Moreover, labetalol's blood pressure-lowering mechanism may be largely independent of changes in sympathetic nervous activity.

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Authors and Affiliations

  1. Medizinische Poliklinik, University of Berne, Switzerland

    G. Keusch,  P. Weidmann M.D., W. H. Ziegler, R. de Châtel & F. C. Reubi

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  1. G. Keusch
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  2. P. Weidmann M.D.
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  3. W. H. Ziegler
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  4. R. de Châtel
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  5. F. C. Reubi
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Keusch, G., Weidmann, P., Ziegler, W.H. et al. Effects of chronic alpha and beta adrenoceptor blockade with labetalol on plasma catecholamines and renal function in hypertension. Klin Wochenschr 58, 25–29 (1980). https://doi.org/10.1007/BF01477140

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  • DOI: https://doi.org/10.1007/BF01477140

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