Diazoxide‐induced Benin Release in Diagnosis of Remediable Renovascular Hypertension*

Stokes, Gordon S.; Weber, Michaela; Gain, J M; Scott, Alastair; Roberts, Brooke; Sheil, A. G. R.

doi:10.1111/j.1445-5994.1976.tb03287.x

Cited by 20 publications

(3 citation statements)

References 12 publications

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“…Mean values for blood pressure, pulse rate, plasma renin activity, and body weight of 15 patients in the double-blind randomized crossover study < 0.01 activity by radioimmunoassay 14. Statistical analyses were made by Student's paired t test.Blood pressure responses in individual patients were graded by the method of Walker and coworkers 15.…”

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confidence: 99%

Indoramin and prazosin as adjuncts to beta adrenoceptor blockade in hypertension

Stokes

Frost

Graham

et al. 1979

Clin Pharma and Therapeutics

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Two trials were conducted on the effects of adding alpha-adrenoreceptor blockers to the therapy of hypertensive patients already receiving a beta-adrenoreceptor blocking drug with or without a diuretic. The first trial was a single-blind study in which 6 patients receiving long-term combination therapy were crossed from prazosin, 6 to 15 mg/day, to a dose of indo ram in 10 times as large. There was significant bradycardia but little change in blood pressure. The second trial was a double-blind randomized crossover study in which 15 patients completed an 8-wk period of treatment with each of the alpha blockers, administered in random sequence with an intervening 2-wk washout period. Dosage was titrated for optimal antihypertensive effect.The final mean dosages were 76 mg /day for indoramin and 8.2 mg /day for prazosin; the dose ratio was 9.3: I. Both drugs reduced erect systolic blood pressure. Prazosin, but not indoramin, reduccd exercise systolic and diastolic pressures. Indoramin lowered supine and exercise pulse rates. Neither drug affected peak expiratory flow rate or plasma renin activity. Analysis of individual responses in supine diastolic blood pressure showed that there were 9 prazosin and 8 indoramin responders, while 9 of the 21 subjects in the 2 trials failed to respond to either drug. Central side effects were more prominent with indoramin. The combination of one or other of these alpha-adrenoreceptor blockers with preexisting beta-adrenoreceptor blockade improved blood pressure control in 57% of the patients.Indoramin and prazosin are post junctional alpha-adrenoreceptor blocking drugs 4 • 9 which lower blood pressure. 7. 13 Prazosin has been used extensively in the treatment of hypertension and has proved effective alone or in combination with other antihypertensive drugs, particularly beta-adrenoreceptor blockers. '2 Indoramin differs from prazosin in its capability to block histamine and 5-hydroxytryptamine receptors' and has been shown to have cardioinhibitory' and bronchodilator 3 properties. Given alone in sufficient dosage to control the blood pressure of hypertensive patients, indoramin has induced a high incidence of somnolence 5 ; its possible role in combination therapy has not been fully evaluated.

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confidence: 99%

Indoramin and prazosin as adjuncts to beta adrenoceptor blockade in hypertension

Stokes

Frost

Graham

et al. 1979

Clin Pharma and Therapeutics

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“…Twelve (38 %) of our 32 successfully operated cases were diagnosed preoperatively only when stimulation results were used. Some earlier studies have also shown that additional renin-positive patients are discovered by such stimulation procedures and successfully treated with surgery (8,9,(22)(23)(24)(25). These studies together report on 60 successful cases, 23 (38 %) of whom appear to have been identified only by their renin pattern after stimulation.…”

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Preoperative Diagnosis of Renovascular Hypertension

Delin

Aurell

Granérus

1984

Journal of Internal Medicine

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The gain in the diagnostic power of the routine preoperative bilateral renal vein renin investigation by the inclusion of an acute stimulation of renin release was studied in 25 hypertensive patients with fibromuscular (FMD) and 44 with arteriosclerotic (AS) renovascular disease. Nine FMD and 17 AS patients had renal vein renin ratios ≥1.50 under unstimulated conditions. Of these 26 patients, 8 in each group improved after surgical treatment. Among the 14 FMD and 24 AS patients with ratios <1.50, another 9 FMD and 7 AS patients improved after operation. After acute stimulation of renin release, no less than 18 FMD and 26 AS patients had a unilateral renin secretion from the diseased kidney and of these, 14 FMD and 14 AS patients were successfully treated with operation of the stenosis. Thus the stimulation was necessary for correct preoperative diagnosis in 38% of 32 successfully operated patients, and at the same time the predictive value of a negative test increased from 0.58 to 0.80. It is concluded that acute stimulation of renin release greatly improves the diagnostic power of the renal vein renin investigation in renovascular hypertension.

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“…In all cases, antihypertensive therapy was withdrawn for one week or longer and then baseline plasma renin activity was determined as previously reported (Stokes et al, 1976). The values obtained were graded as low, normal or high by reference to a nomogram relating 118 determinations of peripheral plasma renin activity (erect posture) to concurrent urinary sodium excretion in 76 normal activity and blood pressure responses to saralasin n.a.…”

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False-negative Saralasin Responses in Renovascular Hypertension

Stokes

MacCarthy

Frost

et al. 1979

British Journal of Urology

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Blood pressure responses to the infusion of saralasin and plasma renin levels were measured in 31 hypertensive patients following preparation with frusemide. Five patients had unilateral renal artery stenosis, with renal vein ratios lateralising strongly to the affected side. Saralasin produced depressor responses in 3 of these but failed to evoke significant effects in the other 2, despite the fact that in both cases hypertension was subsequently alleviated by renal bypass surgery. A further period of more severe sodium depletion increased plasma renin levels and the depressor effect of saralasin, but did not help to differentiate renal artery stenosis from other forms of hypertension.

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Diazoxide‐induced Benin Release in Diagnosis of Remediable Renovascular Hypertension*

Cited by 20 publications

References 12 publications

Indoramin and prazosin as adjuncts to beta adrenoceptor blockade in hypertension

Indoramin and prazosin as adjuncts to beta adrenoceptor blockade in hypertension

Preoperative Diagnosis of Renovascular Hypertension

False-negative Saralasin Responses in Renovascular Hypertension

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