Abstract
The different modes of antihypertensive action of beta-adrenoceptor blocking drugs are reviewed with a special emphasis on renal mechanisms of action. Beta-adrenoceptors occur in the kidney at the level of the juxtaglomerular and tubular cells. Direct intrarenal effects of beta-blockers include the decrease in renin release and the enhanced tubular excretion of fluid and electrolytes. Beta-blockers also influence renal function in a more indirect way by altering the activity of different extrarenally formed hormones with an effect on fluid and electrolyte excretion, such as angiotensin II, atrial natriuretic factors and prostaglandins. Several beta-blockers have an additional effect on the renal vasculature. One of these, tertatolol, is a renal vasodilator beta-blocker in different species. The possible mechanisms of renal vasodilatation of tertatolol are reviewed. It is concluded that the shift of the renal pressure-diuresis curve is an essential feature in the mode of long-term antihypertensive action of beta-blockers.
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