Hemodynamic effects of diuretics in patients with marked peripheral edema and mild hypertension

• Published in: Clinical pharmacology and therapeutics Vol. 31; no. 3; p. 370
• Main Authors: Niarchos, A P, Magrini, F
• Format: Journal Article
• Language: English
• Published: United States 01.03.1982
• Subjects: Adult; Blood Volume - drug effects; Cardiac Output - drug effects; Diuretics - therapeutic use; Edema - complications; Edema - drug therapy; Edema - physiopathology; Hemodynamics - drug effects; Humans; Hypertension - drug therapy; Hypertension - etiology; Liver Cirrhosis - complications; Male; Middle Aged; Nephrotic Syndrome - complications; Vascular Resistance - drug effects
• ISSN: 0009-9236; 1532-6535
• DOI: 10.1038/clpt.1982.47

Hypertension develops in about 10% to 50% of patients with nephrosis or cirrhosis and peripheral edema, but the hemodynamic mechanism of the hypertension and its reversal by diuretic therapy has not been elucidated. In eight patients with marked edema and mild hypertension, diuretics (furosemide and spironolactone) decreased mean arterial pressure because of concurrent decrease in cardiac output and total peripheral resistance. Neither total blood volume nor plasma volume were decreased by the diuretics and the decrease in body weight was therefore attributed to the decrease in interstitial fluid volume. This, in turn, resulted in increased venous capacitance (as can be judged from the diuretic-induced decrease in the ratio of cardiopulmonary blood volume/total blood volume).