Proposed mechanisms of propranolol's antihypertensive effect in essential hypertension

The New England Journal of Medicine
J W HollifieldD G Shand


We studied the antihypertensive effect of propranolol alone and in combination with diuretics in 13 patients with high, 18 with normal and nine with low-renin essential hypertension whose blood-pressure response to diuretics was previously established. Propranolol (160 mg daily) significantly lowered mean arterial pressure in high-renin (129 +/- 2.6 to 114 +/- 2.1 mm Hg) and normal-renin (131 +/- 2.7 to 119 +/- 3.5 mm Hg) patients but not in low-renin patients. A positive correlation (r = 0.36, P less than 0.05) between fall in pressure and fall in plasma renin activity occurred at this dose when the whole group was considered. An antihypertensive effect occurred in both high-renin and low-renin hypertension during large-dose (320 to 960 mg daily) propranolol therapy. This effect was independent of changes in plasma renin activity. The antihypertensive effects of propranolol and diuretics were additive in normal-renin and high-renin hypertension. These data suggest that propranolol's pressure-lowering activity is due to both renin-dependent and renin-independent effects.


Jan 9, 1975·The New England Journal of Medicine·E L BravoH P Dustan
Apr 1, 1975·British Journal of Clinical Pharmacology·T O MorganA E Doyle
Mar 2, 1972·The New England Journal of Medicine·H R BrunnerF R Bühler
Sep 26, 1970·British Medical Journal·D J Coltart, D G Shand
Feb 1, 1972·The Journal of Clinical Endocrinology and Metabolism·A M Michelakis, R G McAllister
Mar 23, 1972·The New England Journal of Medicine·R ZacestJ Koch-Weser
Apr 1, 1973·Minerva cardioangiologica·B MagnaniM Sanguinetti
Jun 1, 1972·American Heart Journal·F J ZachariasB G Wall
Jan 1, 1970·Clinical Pharmacology and Therapeutics·D G ShandJ A Oates
Jan 4, 1969·British Medical Journal·B N Prichard, P M Gillam


Jan 1, 1979·Journal of Clinical Pharmacology·I GavrasH R Brunner
Jun 1, 1991·Cardiovascular Drugs and Therapy·D McAreaveyJ I Robertson
Oct 1, 1987·American Heart Journal·B N Prichard, B Tomlinson
Jan 1, 1983·Pharmacology & Therapeutics·A J Scriven, P J Lewis
Jan 1, 1992·Pharmacology & Therapeutics·G D Johnston
Nov 4, 1976·The New England Journal of Medicine
Oct 16, 1980·The New England Journal of Medicine·W A Pettinger
Jan 1, 1982·Journal of Psychoactive Drugs·J Buffum
Jul 1, 1979·British Journal of Clinical Pharmacology·I B DaviesT Rosenthal
Jan 1, 1985·Clinical and Experimental Pharmacology & Physiology·I W ReimannJ C Frölich
Jul 13, 1985·British Medical Journal·A Breckenridge
Jan 1, 1985·Clinical and Experimental Hypertension. Part A, Theory and Practice·M A van BaakJ F Smits
Jun 1, 1980·Scandinavian Journal of Clinical and Laboratory Investigation·H IbsenJ Giese
Jan 1, 1986·Current Medical Research and Opinion·C I BackhouseL Spencer-Mills
Jul 1, 1988·Medical Toxicology and Adverse Drug Experience·D E McWaine, W R Procci
Jun 1, 1978·British Journal of Obstetrics and Gynaecology·H E EliahouD M Serr
Jul 1, 1982·Pediatric Annals·L Reisman, R V Selden
Nov 1, 1981·Clinics in Endocrinology and Metabolism·S A Atlas, D B Case
Jul 1, 1977·The American Journal of Cardiology·A Zweifler, M Esler
Jan 29, 1988·The American Journal of Medicine·A Breckenridge
Oct 1, 1979·Circulation·R L WoosleyJ A Oates
Jan 1, 1986·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·B WillemsP M Huet
May 1, 1982·Clinical Cardiology·D T O'Connor, R A Preston
Jan 1, 1986·British Journal of Clinical Pharmacology·B N Prichard, C W Owens
Jan 26, 2011·European Journal of Clinical Investigation·Chin-Chou HuangJaw-Wen Chen
Feb 1, 1987·Postgraduate Medicine·F H Messerli
Jan 1, 1987·British Journal of Clinical Pharmacology·A Breckenridge
Mar 1, 1977·Postgraduate Medicine·R W Gifford
Mar 1, 1983·British Journal of Clinical Pharmacology·F H LeenenE J Dorhout Mees
Nov 1, 1981·The Journal of Urology·A C Novick
Jul 1, 1985·Journal of Clinical Pharmacology·G T Griffing, J C Melby
Oct 14, 2004·Journal of Hypertension·Ivar K EideNils P Lilledahl
Feb 1, 1984·Drug Intelligence & Clinical Pharmacy·J G Stevenson, G S Umstead

Related Concepts

Diastolic Blood Pressure
Clinical Trials
Depression, Chemical
Diuretic Effect
Dose-Response Relationship, Drug
Hypertensive Disease

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.