Antihypertensive and renal haemodynamic effects of atenolol and nadolol in elderly hypertensive patients

O'Callaghan, W.G.; Laher, M.S.; McGarry, K.; O'Brien, E.; O'Malley, K.

British Journal of Clinical Pharmacology 16(4): 417-421


ISSN/ISBN: 0306-5251
PMID: 6138058
Accession: 004757881

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As little is known of the antihypertensive efficacy or renal hemodynamic effects of .beta.-adrenoceptor blocking drugs in the elderly, 2 such drugs, atenolol and nadolol, were studied in elderly hypertensive patients. Ten patients took part in a placebo-controlled double-blind study of atenolol and 10 received nadolol in a single-blind placebo-controlled study. Treatment phases lasted 12 wk for atenolol or 10 wk for nadolol. Blood pressure, effective renal blood flow and glomerular filtration rate data obtained at the end of each treatment phase were analyzed. Atenolol lowered mean arterial pressure from 129.9 .+-. 1.5 to 108.2 .+-. 2.3 mm Hg (P < 0.01) while it increased mean effective renal blood flow from 512.5 .+-. 86.6 to 646.0 .+-. 116.1 ml/min per 1.73 m2 (P < 0.05). Nadolol reduced mean arterial pressure from 133.2 .+-. 2.0 to 113.5 .+-. 3 mm Hg (P < 0.001) but reduced mean effective renal blood flow from 558.8 .+-. 32.2 to 446.0 .+-. 26.9 ml/min per 1.73 m2 (P < 0.05). Glomerular filtration did not alter significantly with either drug. Evidently .beta.-adrenoceptor blocking drugs are effective antihypertensive agents in the elderly but have disparate effects on effective renal blood flow perhaps because of differences in cardioselectivity. Comparative studies with thiazide diuretics and .beta.-adrenoceptor blocking drugs are warranted in elderly hypertensives.