Blood pressure, body fluid volumes and glomerular filtration rate during treatment with labetalol in essential hypertension.

Rasmussen, Sten Nørby; Nielsen, P. E.

doi:10.1111/j.1365-2125.1981.tb01225.x

Cited by 25 publications

(3 citation statements)

References 27 publications

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“…In general, the chronic use of propranolol for the management of hypertension is associated with 10%-20% decrements in RBF and GFR [21][22][23]. In contrast, labetalol, a [3-blocker with (z-blocking activity, spares renal haemodynamics [25,26]. Against this background, we found it of interest to study the effects of carvedilol on renal haemodynamics.…”

Section: Discussionmentioning

confidence: 94%

Effects of carvedilol on renal function

Dupont

1990

Eur J Clin Pharmacol

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A randomized, double-blind, placebo-controlled study was conducted to study the effects of acute and chronic administration of carvedilol in essential hypertension, with special emphasis on renal haemodynamics and function. Acute administration of a single dose of 50 mg carvedilol reduced systolic and diastolic blood pressure without inducing reflex tachycardia. Renal blood flow was preserved; accordingly, renal vascular resistance was significantly reduced. A significant reduction in the glomerular filtration rate and filtration fraction was observed. Plasma renin activity (PRA) and plasma aldosterone values were not changed. Chronic carvedilol treatment produced a significant fall in systolic and diastolic blood pressure, heart rate, PRA and plasma aldosterone. Renal blood flow, glomerular filtration rate and filtration fraction also remained unchanged; renal vascular resistance decreased significantly. It is concluded that carvedilol possesses definite antihypertensive and renal vasodilating properties, both acutely and after chronic treatment.

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Section: Discussionmentioning

confidence: 94%

Effects of carvedilol on renal function

Dupont

1990

Eur J Clin Pharmacol

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“…Several trials from the 1980s in patients with hypertension treated with different beta‐blockers revealed conflicting results regarding influence on erectile function, but these data were limited. In most trials, erectile dysfunction was not the primary objective and was assessed by patient‐reports, instead of evaluation with a questionnaire or measurement of penile rigidity (19–22).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk, drugs and erectile function - a systematic analysis

Baumhäkel

Schlimmer

Kratz

et al. 2011

International Journal of Clinical Practice

115

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Summary Aims: Erectile dysfunction is a major problem with an increasing prevalence in cardiovascular high‐risk patients due to its association with cardiovascular risk factors. Drugs used for evidence‐based treatment of cardiovascular diseases have been reported to decrease erectile function, but possible mechanisms are poorly characterised. Methods: MEDLINE, EMBASE and Cochrane Registry search were performed including manuscripts until January 2010. Searching terms are: ‘erectile dysfunction or impotence’ in combination with ‘ACE‐inhibitors’, ‘angiotensin’, ‘beta‐blockers’, ‘calcium antagonist’ and ‘diuretics’. Animal studies, letters, reviews, case‐reports and manuscripts other than English language and trials dealing with combination treatment are excluded. Results: Analysis of literature revealed five epidemiological trials evaluating the effect of different cardiovascular drugs on erectile function. There were eight trials evaluating the effect of beta‐blockers, five trials evaluating the effect of ace‐inhibitors or angiotensin‐receptor‐blockers and one trial evaluating the effect of diuretics on erectile function. Results of these trials demonstrate that only thiazide diuretics and beta‐blockers except nebivolol may adversely influence erectile function. ACE‐inhibitors, angiotensin‐receptor‐blockers and calcium‐channel‐blockers are reported to have no relevant or even a positive effect on erectile function. Conclusion: Inappropriate patients’ concerns about adverse effects of cardiovascular drugs on erectile function might limit the use of important medications in cardiovascular high‐risk patients. Knowledge about the effects of drug‐treatments on erectile function and about the major role of the endothelium in penile function might improve patients’ adherence to evidence based treatment of cardiovascular diseases.

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“…84 By contrast, in 18 patients with essential hypertension labetalol diminished RBF and GFR by 20% 85 Two studies in patients with normal renal function, one including 17 patients and the other including 11 patients, found no significant effect of labetalol on GFR, RBF, or body fluid volumes. 36,86 The effects of labetalol on carbohydrate and lipid metabolism have also been evaluated in small studies. Labetalol administration resulted in a variable increase in serum glucose levels without a measurable effect on circulating insulin levels.…”

Section: Vasodilating B-blockersmentioning

confidence: 99%

Beta blockers in the management of chronic kidney disease

Bakris

Hart

Ritz

2006

Kidney International

176

115

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The sympathetic nervous system modulates renal function through its receptors namely beta1 (cardiac output and renin release), alpha1 (systemic and renovascular constriction), and beta2 renovascular dilation. Sympathetic overactivity is commonly seen in chronic kidney disease (CKD) and is an important contributor to increasing the risk of cardiovascular events as well as increasing renal disease progression. Recent evaluations of drug use in people with CKD shows a remarkably low percentage of patients receiving beta-blockers, especially in more advanced stage CKD when cardiovascular risk is higher. This is in large part due to tolerability of these agents. Moreover, water-soluble beta-blockers such as atenolol and metoprolol are dialyzable and require supplementation to avoid exacerbation of arrhythmias following dialysis. Newer vasodilating beta-blockers have better tolerability and different effects on renal hemodynamics as well as metabolic variables. These effects are related to the relative alpha1-blocking effect of agents such as carvedilol and labetolol, with carvedilol having relatively greater alpha-blocking effects. Few studies evaluate beta-blockers on cardiovascular risk in CKD patients. Studies with carvedilol demonstrate attenuated increases in albuminuria as well as reduction in cardiovascular events in CKD patients with hypertension. This paper reviews the animal and clinical trial data that evaluate beta-blockers in CKD highlighting the vasodilating beta-blockers. It is apparent that greater use of this drug class for blood pressure control would further enhance reduction of risk of heart failure, the most common cause of death in the first year of starting dialysis.

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Blood pressure, body fluid volumes and glomerular filtration rate during treatment with labetalol in essential hypertension.

Cited by 25 publications

References 27 publications

Effects of carvedilol on renal function

Effects of carvedilol on renal function

Cardiovascular risk, drugs and erectile function - a systematic analysis

Beta blockers in the management of chronic kidney disease

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