The Short-Term Effects of Reducing Elevated Blood Pressure in Elderly Patients With Propranolol and Dyazide

Abstract

Propranolol and Dyazide (25 mg hydrochlorothiazide and 50 mg triamterene) were used singly to reduce the elevated blood pressure (systolic ranging from 170 to 271 mmHg and diastolic ranging from 100 to 141 mmHg) of 38 elderly hypertensive patients whose ages ranged from 69 to 91 years. Each compound was administered for a period of four weeks with a wash-out period of four weeks in between. The following parameters were assessed before and after each treatment period: cerebral blood flow (CBF), mental functions, cardiac output (CO), electrocardiogram, glomerular filtration rate (GFR) and serum biochemistry. Both systolic and diastolic blood pressure were significantly reduced following the administration of either compound. No significant change in CBF and CO could be observed after reducing the blood pressure whether Propranolol or Dyazide was used. The GFR was, however, significantly reduced and the plasma creatinine significantly increased following Dyazide but not Propranolol administration. As expected the administration of the latter compound was associated with a significant bradycardia. No significant change could be observed in the other parameters studied.

Effect of Antihypertensive Treatment on Cerebral Blood Flow in Older Adults: a Systematic Review and Meta-Analysis

“…Thirty studies included participants with hypertension. 27–54,56,57 Six studies included participants with dementia or MCI. 26,27,29,31,54,55 Fifteen studies used a calcium channel blocker, 26,29,31,32,34,36,38,39,43,44,47,48,52,55,57 but our data also included angiotensin receptor blockers, 27,31,36,49,50 diuretics, 27,28,36,38–40,42,51,52 angiotensin-converting enzyme inhibitors, 27,30,36,37,41,42,44,53,54,56 β blockers, 28,30,37,45,46,48 and α blockers.…”

“…27–54,56,57 Six studies included participants with dementia or MCI. 26,27,29,31,54,55 Fifteen studies used a calcium channel blocker, 26,29,31,32,34,36,38,39,43,44,47,48,52,55,57 but our data also included angiotensin receptor blockers, 27,31,36,49,50 diuretics, 27,28,36,38–40,42,51,52 angiotensin-converting enzyme inhibitors, 27,30,36,37,41,42,44,53,54,56 β blockers, 28,30,37,45,46,48 and α blockers. 36,44,48 Measurement techniques for CBF were 133-Xenon inhalation technique, 28,33,37–39,44–46,53,56 arterial spin labeling, 26,35,36 single photon emission computed tomography, 29,31,32,40,42,49,51,52,54 transcranial Doppler, 26,27,48,57 and PET.…”

“…Fourteen studies were randomized controlled trial’s, 26–39 one was a nonrandomized trial (comparing hydrochlorothiazide with no medication without randomizing the groups) 40 and seventeen were prestudies and poststudies, 41–57 6 of which used a cross-over design. 28,37–40,46 Twenty-three studies investigated chronic effects of AHT, 26–32,34–36,40–42,45–47,49–51,53,54 5 investigated acute effects, 43,44,48,55 and 4 studies investigated both. 33,39,52,57 Sample sizes ranged from 6 to 673 participants with the mean age ranging from 50 to 79 years.…”

“…35 Regional CBF Thirteen studies investigated regional CBF. 26,28,29,31,32,34,36,42,47,49,50,52,54 Only 5 studies showed significant changes (mostly increases) in CBF in specific brain regions. 26,29,31,52,54 However, these regions were not consistent across the 5 studies.…”

“…Fourteen studies were randomized controlled trial's, [26][27][28][29][30][31][32][33][34][35][36][37][38][39] one was a nonrandomized trial (comparing hydrochlorothiazide with no medication without randomizing the groups) 40 and seventeen were prestudies and poststudies, [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] 6 of which used a cross-over design. 28,[37][38][39][40]46 Twenty-three studies investigated chronic effects of AHT, [26][27][28][29][30][31][32][34][35][36][40]…”