Effects of diuretic therapy in low-, normal- and high-benin isolated systolic systemic hypertension

• Published in: The American journal of cardiology Vol. 53; no. 6; pp. 797 - 801
• Main Authors: Niarchos, Andreas P., Laragh, John H.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.03.1984
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(84)90407-7

In 30 patients with isolated systolic systemic hypertension, diuretic therapy decreased body weight from 71.33 ± 2.67 ± to 70.37 ± 2.65 kg (p < 0.0005) and the systolic blood pressure from 174 ± 3 to 156 ± 3 mm Hg (p < 0.0005). Diastolic blood pressure and heart rate did not change significantly. Plasma renin activity increased from 2.25 ± 0.33 to 4.27 ±0.43 ng/ml/hour (p < 0.0005) and urinary aldosterone from 9 ± 1 to 16 ± 2 μg/24 hours (p < 0.005). The antihypertensive effect of diuretics was significantly related only to the pretreatment plasma renin activity (r = −0.50, n = 30, p < 0.05) and therefore the greatest decrease in systolic blood pressure occurred in the low-renin group, whereas the smallest occurred in the high-renin group (-22 ±2 vs −3 ± 9 mm Hg, p < 0.005). The diastolic blood pressure was significantly decreased only in the low-renin group (−7 ± 2 mm Hg, p < 0.005). There were no significant changes in blood pressure in 11 untreated control patients. These results indicate that diuretics are effective antihypertensive agents in most patients with low- and normal-renin isolated systolic systemic hypertension.